心肺运动试验指导下四肢联动训练治疗脑卒中后非特异性腰痛的效果研究  

Effect of Limb Linkage Training under the Guidance of Cardiopulmonary Exercise Test on Nonspecific Low Back Pain after Stroke

作　　者：章金蓉[1] 包凤岐 费惠慧[1] 潘洁 陈兰 何俊[1] ZHANG Jinrong;BAO Fengqi;FEI Huihui;PAN Jie;CHEN Lan;HE Jun(Department of Rehabilitation,Changzhou Dean Hospital,Changzhou 213000,China;Department of Hospital Infection-control,Changzhou Hospital of Traditional Chinese Medicine,Changzhou 213000,China)

机构地区：[1]江苏省常州市德安医院康复科,213000 [2]江苏省常州市中医医院院感科,213000

出　　处：《实用心脑肺血管病杂志》2022年第1期117-123,共7页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

基　　金：常州市卫计委青年人才科技项目(QN201827)。

摘　　要：背景脑卒中后非特异性腰背痛(NLBP)发病率较高,极大影响患者功能恢复和生活质量;当前脑卒中后NLBP的治疗手段单一,以口服镇痛类药物为主,长期服用不良反应明显。脑卒中后NLBP与肢体平衡和运动障碍密切相关,而心肺运动试验(CPET)指导下四肢联动训练正是改善肢体平衡和运动障碍的有效方法。目的探讨CPET指导下四肢联动训练治疗脑卒中后NLBP的效果。方法选取2019年10月至2020年12月在常州市德安医院康复中心就诊的脑卒中后NLBP患者60例,采用随机数字表法分为对照组30例、观察组30例。对照组有2例患者、观察组有1例患者中途自行退出本研究,最终纳入患者57例,其中对照组28例、观察组29例。对照组给予常规康复训练,观察组在常规康复训练基础上增加CPET指导下四肢联动训练,持续训练6周。比较两组患者训练前后视觉模拟评分法(VAS)评分、两侧腹直肌与腰段腰段竖脊肌平均功率频率(MPF)、Berg平衡量表(BBS)评分、FuglMeyer运动功能评定量表(FMAS)评分以及步态参数。结果训练后两组患者静息、步行状态下VAS评分分别低于本组训练前,且观察组患者静息、步行状态下VAS评分低于对照组(P<0.05)。训练后两组患者患侧及健侧腹直肌、腰段竖脊肌MPF分别高于本组训练前,且观察组患者患侧及健侧腹直肌、腰段竖脊肌MPF高于对照组(P<0.05)。训练后两组患者BBS及FMAS上肢部分、下肢部分评分分别高于本组训练前,且观察组患者FMAS上肢部分、下肢部分评分高于对照组(P<0.05)。训练后两组患者步幅、步频、步速、健侧摆动相/患侧摆动相分别高于本组训练前,步长偏差、健侧支撑相/患侧支撑相分别低于本组训练前,且观察组患者步幅、步频、步速、健侧摆动相/患侧摆动相高于对照组,步长偏差、健侧支撑相/患侧支撑相低于对照组(P<0.05)。结论在常规康复训练基础上增加CPET指Background The incidence of nonspecific low back pain(NLBP)after stroke is high,which greatly affects patients'functional recovery and quality of life.Moreover,the current treatment of NLBP after stroke is single,mainly oral analgesics,and long-term adverse reactions are obvious.After stroke,NLBP is closely related to limb balance and movement disorder,and limb linkage training guided by cardiopulmonary exercise test(CPET)is an effective method to improve limb balance and movement disorder.Objective To investigate the effect of limb linkage training guided by CPET on NLBP after stroke.Methods A total of 60 patients with NLBP after stroke who were admitted to Rehabilitation Center of Changzhou Dean Hospital from October 2019 to December 2020 were selected and divided into control group(n=30)and observation group(n=30)by random number table method.Two patients of control group and 1 patient of observation group exited during the study.Eventually there were 57 patients included in the study(28 patients in the control group,29 patients in the observation group).The control group was given routine rehabilitation training,and the observation group was given limb linkage training guided by CPET on the basis of routine rehabilitation training.The training lasted for 6 weeks.Visual Analogue Scale(VAS)scores,mean power frequency(MPF)of bilateral rectus abdominis and lumbar erector spine muscles,Berg Balance Scale(BBS)scores,Fugl-Meyer Assessment Scale(FMAS)scores and gait parameters were compared between the two groups before and after training.Results After training,VAS scores in resting and walking state in the two groups were lower than those before training,respectively,and VAS scores in resting and walking statee in the observation group were lower than those in the control group(P<0.05).After training,the MPF of bilateral rectus abdominis and lumbar erector spine muscles of patients in the two groups were higher than those before training,respectively,and the MPF of bilateral rectus abdominis and lumbar erector spine

关 键 词：卒中 非特异性腰痛 四肢联动训练 心肺运动试验 

分 类 号：R743[医药卫生—神经病学与精神病学]