悬吊运动疗法联合吸气肌力量训练对脑卒中偏瘫患者的影响  

Effect of Sling Exercise Therapy combined with Inspiratory Muscle Strength Training for Stroke Patients with Hemiplegia

作　　者：孙文琳[1] 孟殿怀[2] 刘阳阳 苏小勇 刘洋 张芳芳 赵甜甜 SUN Wenlin;MENG Dianhuai;LIU Yangyang;SU Xiaoyong;LIU Yang;ZHANG Fangfang;ZHAO Tiantian(The First Affiliated Huai'an Hospital of Nanjing Medical University,Huai'an,Jiangsu 223300,China;The First Affiliated Hospital of Nanjing Medical University,Nanjing,Jiangsu 210029,China)

机构地区：[1]南京医科大学附属淮安第一医院,江苏淮安223300 [2]南京医科大学第一附属医院,江苏南京210029

出　　处：《康复学报》2021年第4期279-285,共7页Rehabilitation Medicine

基　　金：江苏省重点研发计划(社会发展)项目(BE2020718)。

摘　　要：目的:观察悬吊运动疗法联合吸气肌力量训练对脑卒中偏瘫患者平衡功能、步行功能的影响。方法:选取2018年1月—2020年8月在南京医科大学附属淮安第一医院康复医学科住院治疗的脑卒中偏瘫患者72例,使用随机数字表法分为对照组、悬吊组和联合组,每组24例。对照组接受常规药物联合常规康复训练(包括关节活动度训练、本体感觉神经促进技术、立位平衡训练、步行训练及日常生活活动能力训练等),其中康复训练40 min/次,2次/d,5 d/周,共训练6周。悬吊组在对照组基础上接受悬吊运动疗法,主要包括:躯干控制训练、下肢分离运动强化训练和腰部悬吊减重状态下双下肢交替训练,以上3个动作循环交替训练,每个训练动作末保持5 s,再休息5 s,20 min/次,2次/d,5 d/周,共训练6周。联合组在悬吊组基础上接受吸气肌力量训练,20 min/次,1次/d,5 d/周,共训练6周。治疗前和治疗6周后分别采用最大吸气压(MIP)、吸气峰流速(PIF)、用力肺活量(FVC)评定患者肺功能和吸气肌功能;采用Berg平衡量表(BBS)评估患者平衡能力;采用Fugl-Meyer运动功能(FMA-LE)评定量表评定患者下肢运动功能;采用10 m最大步行速度(10 m MWS)评定患者步行速度。结果:3组治疗前MIP、PIF、FVC、BBS评分、FMA-LE运动功能评分和10 m MWS比较,差异均无统计学意义(P>0.05)。与治疗前比较,3组治疗6周后MIP、PIF、FVC、BBS评分、FMALE运动功能评分和10 m MWS均明显提高,差异具有统计学意义(P<0.05)。与对照组比较,悬吊组和联合组治疗6周后MIP、PIF、FVC、BBS评分、FMA-LE运动功能评分和10 m MWS均明显提高,差异只有统学意义(P<0.05)。与悬吊组比较,联合组治疗6周后MIP、PIF、FVC、BBS评分、FMA-LE运动功能评分和10 m MWS均明显更高,差异具有统计学意义(P<0.05)。结论:悬吊运动疗法联合吸气肌力量训练可以有效提高脑卒中偏瘫患者的平衡功能和步行功�Objective:To observe the effect of sling exercise therapy combined with inspiratory muscle strength training on the balance and walking for stroke patients with hemiplegia.Methods:A total of 72 stroke patients with hemiplegia who were hospitalized in the Department of Rehabilitation Medicine of the first Affiliated Huai'an Hospital of Nanjing Medical University from January 2018 to August 2020,which were divided into the control group,the sling group and the combined group according to the random number table method,with 24 cases in each group.The control group received conventional drugs combined with conventional rehabilitation training(including joint range of motion training,PNF techniques,standing balance training,walking training,and activity of daily living training,etc.),rehabilitation training for 40 minutes a time,twice a day,five days a week,continous training for six weeks.The sling group received sling exercise therapy on the basis of the control group,which mainly included trunk control training,intensive training of lower limb separation exercises,and alternate training of both lower limbs under the condition of waist sling for weight loss.The above three exercises should be trained alternately,hold for five seconds at the end of each exercise,and then rest for five seconds,20 minutes one time,twice a day,five days a week,contionus training for six weeks.The combined group received inspiratory muscle strength training on the basis of the sling group,20 minutes one time,one time a day,five days a week,contionus training for six weeks.Before and after treatment for six weeks,the maximum inspiratory pressure(MIP),peak inspiratory flow(PIF),and forced vital capacity(FVC)were used to assess the lung function and inspiratory muscle function of patients;the Berg balance scale(BBS)was used to assess patients balance ability;the Fugl-Meyer assessment lower extremity(FMA-LE)was used to assess the patient's lower limb motor function;10-meter maximum walking speed(10 m MWS)was used to assess the patient's walk

关 键 词：脑卒中 偏瘫 悬吊运动疗法 吸气肌力量训练 平衡功能 步行功能 

分 类 号：R743.3[医药卫生—神经病学与精神病学]