步行轮椅训练对高龄行走困难患者下肢肌力的影响  

Effect of walking wheelchair training on lower limb muscle strength in elderly patients with walking difficulties

作　　者：秦雯[1] 王峥[1] 白姣姣 李勇 李敏[1] 王俊思 Qin Wen;Wang Zheng;Bai Jiaojiao;Li Yong;Li Min;Wang Junsi(Department of Geriatrics,Huadong Hospital Affiliated to Fudan University,Shanghai,200040,P.R.China;Department of Nursing,Huadong Hospital Affiliated to Fudan University,Shanghai,200040,P.R.China;Department of Rehabilitation Medicine,Huadong Hospital Affiliated to Fudan University,Shanghai,200040,P.R.China)

机构地区：[1]复旦大学附属华东医院老年科,上海200040 [2]复旦大学附属华东医院护理部,上海200040 [3]复旦大学附属华东医院康复医学科,上海200040

出　　处：《老年医学与保健》2020年第4期677-680,共4页Geriatrics & Health Care

基　　金：美国Dreyfus健康基金会PSBH项目(PSBH2018037);上海市中西医结合学会社区医学与健康管理研究项目(SQ7);复旦大学复星护理科研基金项目(FNF201817)。

摘　　要：目的评价步行轮椅训练对高龄行走困难患者的康复效果。方法选取2019年1月—2019年6月,住院的34例高龄行走困难患者,进行6个月步行轮椅训练,比较干预前后患者下肢伸肌与屈肌的力矩峰值(PT)、总计做功(STW)与日常生活活动能力的变化情况。结果干预后,右侧伸肌在不同运动角速度时PT均高于干预前(P<0.05),右侧屈肌在90°/s、180°/s时PT高于干预前(P<0.05);左膝伸肌在90°/s、屈肌在120°/s时PT高于干预前(P<0.05)。右膝伸肌与屈肌在不同运动角速度时STW均高于干预前(P<0.01),左膝伸肌在90°/s、屈肌在120°/s时STW高于干预前(P<0.01)。34例高龄患者的Barthel指数得分较干预前升高[(57.29±2.05)分vs(41.57±1.21)分,P<0.01],差异有统计学意义。结论步行轮椅训练有利于改善高龄行走困难患者下肢膝关节肌力、活动耐力以及日常生活活动能力。Objective To evaluate the effect of walking wheelchair training on lower limb muscle strength in elderly patients with walking difficulties.Methods From January 2019 to June 2019,34 elderly hospitalized patients with walking difficulties were selected for 6-month walking wheelchair training.The changes of peak torque(PT),set total work(STW)and activities of daily living of lower limb extensor and flexormuscles were compared before and after the intervention.Results After training,the PT of the right extensor was higher than that before the intervention at different angular velocities(P<0.05),the PT of the right flexor was higher than that before the intervention at 90°/s and 180°/s(P<0.05);the PT of the left extensor at 90°/s and flexor at 120°/swere higher than those before the intervention(P<0.05);the STWof the right extensor and flexor were higher than those before the intervention at different angular velocities(P<0.01),the STWof the left extensor at 90°/s and flexor at 120°/s were higher than those before the intervention(P<0.01);and the Barthel index score of all patients was higher than that before the intervention[(57.29±2.05)vs(41.57±1.21),P<0.01].Conclusion Walking wheelchair training is beneficial to improve the lower limb knee muscle strength,activity endurance and activity of daily living in the elderly patients with walking difficulties.

关 键 词：轮椅训练 肌力 肌肉耐力 日常生活活动 

分 类 号：R493[医药卫生—康复医学]