等速肌力训练对脑卒中后上肢功能障碍患者上肢运动功能的影响  

Influence of isokinetic muscle strength training on upper limb motor function patients with upper limb dysfunction affer stroke

作　　者：李雅薇[1] 黄宇涛[1] 王坤[1] LI Ya-wei;HUANG Yu-tao;WANG Kun(Department of Rehabilitation Medicine,Shenzhen Second People's Hospital,Shenzhen,Guangdong,518035,China)

机构地区：[1]深圳市第二人民医院康复医学科,广东深圳518035

出　　处：《心血管康复医学杂志》2020年第2期137-141,共5页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:研究等速肌力训练对脑卒中患者上肢运动功能的影响。方法:2016年1月-2017年10月于我院治疗的90例脑卒中后上肢功能障碍患者被随机均分为常规康复组和联合训练组(在常规康复组基础上接受等速肌力训练),两组均治疗4周。观察比较两组治疗前后Fugl-Meyer运动功能量表(FMA)评分、改良Ashworth量表(MAS)评分、改良Barthel指数(MBI)评分及以角速度60°/s、120°/s伸屈时肘伸肌、肘屈肌峰力矩(PT)、总功(TW)、平均功率(AP)。结果:与治疗前比较,治疗后两组FMA评分、MBI评分、以角速度60°/s、120°/s伸屈时肘伸肌及肘屈肌PT、TW、AP均显著升高(P均=0.001),治疗后两组MAS评分无显著差异(P均>0.05)。与常规康复组比较,联合训练组治疗后FMA评分[(49.28±6.73)分比(56.79±6.24)分]、MBI评分[(59.92±9.33)分比(70.14±9.39)分]、以角速度60°/s、120°/s伸屈时肘伸肌:PT[60°/s(17.25±3.66)N·m比(21.48±4.21)N·m,120°/s(10.74±3.80)N·m比(15.69±4.21)N·m]、TW[60°/s(165.74±20.51)J比(194.67±23.55)J,120°/s(209.67±25.28)J比(258.76±26.72)J]、AP[60°/s(11.28±3.35)W比(15.42±4.14)W,120°/s(11.58±3.65)W比(17.83±3.74)W]升高更显著(P均=0.001),以角速度60°/s、120°/s伸屈时肘屈肌:PT、TW、AP均无显著差异(P均>0.05)。结论:等速肌力训练可显著促进脑卒中后上肢功能障碍患者上肢运动功能的恢复,提高日常生活活动能力。Objective:To study influence of sokinetic muscle strength training on upper limb motor function of patients with upper limb dysfunction after stroke.Methods:A total of 90 patients with upper limb dysfunction after stroke treated in our hospital from Jan 2016 to Oct 2017 were randomly and equally divided into routine rehabilitation group and combined training group(received sokinetic muscle strength training based on routine rehabilitation group).Both groups were treated for four weeks.Scores of Fugl-Meyer motor assessment(FMA)scale,modified Ashworth scale(MAS)and modified Barthel index(MBI),peak torque(PT),total work(TW)and average power(AP)of elbow extensor and elbow flexor when elbow flexion at angular velocities of 60°/s and 120°/s were observed and compared between two groups before and after treatment.Results:Compared with before treatment,after treatment,there were significant rise in scores of FMA and MBI,PT,TW and AP of elbow extensor and elbow flexor when elbow flexion at angular velocities of 60°/s and 120°/s in two groups(P=0.001 all),and there was no significant difference in score of MAS in two groups(P>0.05 all).Compared with routine rehabilitation group,there were significant rise in scores of FMA[(49.28±6.73)scores vs.(56.79±6.24)scores]and MBI[(59.92±9.33)scores vs.(70.14±9.39)scores];PT[60°/s(17.25±3.66)N m vs.(21.48±4.21)N·m,120°/s(10.74±3.80)N·m vs.(15.69±4.21)N·m];TW[60°/s(165.74±20.51)J vs.(194.67±23.55)J,120°/s(209.67±25.28)J vs.(258.76±26.72)J]and AP[60°/s(11.28±3.35)W vs.(15.42±4.14)W,120°/s(11.58±3.65)W vs.(17.83±3.74)W]of elbow extensor when Elbow flexion at angular velocities of 60°/s and 120°/s(P=0.001 all),and no significant difference in PT,TW and AP of elbow flexor when elbow flexion at angular velocities of 60°/s and 120°/s in combined training group(P>0.05 all).Conclusion:Isokinetic muscle strength training can significantly promote rehabilitation of upper limb motor function and improve activities of daily living in patients with upper limb dysfu

关 键 词：卒中 肌力 日常生活活动 

分 类 号：R743.309[医药卫生—神经病学与精神病学]