悬吊推拿运动技术对脑卒中患者核心肌群及姿势控制能力的影响  

Effect of Suspension Massage Exercise Technique on Core Muscle Mass and Postural Control Ability of Patients with Stroke

作　　者：孙杰[1] 陈贵娟 徐涵 张天钰 丁懿 王淑睿 李丽[3] SUN Jie;CHEN Guijuan;XU Han;ZHANG Tianyu;DING Yi;WANG Shurui;LI Li(Shandong University of Traditional Chinese Medicine,Jinan,Shandong 250355,China;Xingming Hospital of Xiangcheng Town,Lanling County,Linyi,Shandong 277737,China;The Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan,Shandong 250001,China)

机构地区：[1]山东中医药大学,山东济南250355 [2]兰陵县向城镇兴明卫生院,山东临沂277737 [3]山东中医药大学第二附属医院,山东济南250001

出　　处：《康复学报》2022年第5期441-448,共8页Rehabilitation Medicine

基　　金：山东省重点研发计划项目(2017GSF19114);山东省医药卫生科技发展计划项目(202020010789、202014050815)。

摘　　要：目的:探讨悬吊推拿运动技术对脑卒中患者核心肌群及姿势控制能力的影响。方法:选取符合纳排标准的脑卒中后姿势控制障碍患者58例,采用随机数字表法分为对照组和试验组,每组29例。最终对照组纳入27例,试验组纳入29例。对照组选用常规康复训练,试验组在对照组的基础上运用悬吊推拿运动技术治疗。分别在治疗前和治疗4周后采用脑卒中患者姿势评定量表(PASS)、Berg平衡量表(BBS)、简式Fugl Meyer运动功能量表下肢部分(FMA-LE)、改良Barthel指数(MBI)进行评价,运用表面肌电图(sEMG)测定患者双侧竖脊肌和多裂肌的中值频率(MF)和积分肌电值(iEMG)。结果:2组治疗前PASS、BBS、FMA-LE、MBI评分以及双侧竖脊肌和多裂肌MF值、iEMG值比较,差异无统计学意义(P>0.05)。2组治疗后PASS、BBS、FMA-LE、MBI评分均高于同组治疗前(P<0.05)。试验组患侧竖脊肌和多裂肌MF值、iEMG值及健侧竖脊肌和多裂肌MF值均高于同组治疗前(P<0.05)。治疗后组间比较,2组PASS、BBS、FMA-LE、MBI评分比较,差异均有统计学意义(P<0.05);2组患侧竖脊肌和多裂肌MF值、iEMG值比较,差异均有统计学意义(P<0.05);2组健侧多裂肌MF值比较,差异有统计学意义(P<0.05)。相关性分析结果显示,PASS总分与患侧竖脊肌MF值呈正相关(r=0.404,P=0.030),PASS评分与患侧多裂肌MF值、iEMG值均呈正相关(r=0.443,P=0.016;r=0.412,P=0.026),PASS总分与健侧多裂肌MF值、iEMG值呈正相关(r=0.728,P=0.000;r=0.407,P=0.028),姿势变换维度评分与健侧多裂肌MF值、患侧多裂肌iEMG值呈正相关(r=0.609,P=0.000;r=0.381,P=0.042)。结论:悬吊推拿运动技术可有效改善脑卒中后姿势控制障碍,提高患者躯干核心肌群收缩效能及姿势控制能力,降低肌肉疲劳度,值得临床推广应用。Objective:To investigate effect of suspension massage exercise technique on core muscle mass and posture control ability of patients with stroke.Methods:A total of 58 patients with postural control disorders after stroke who met the inclusion and exclusion criteria were recruited and randomly divided into control group and experiment group,with 29 patients in each group.In the end,27 cases were included in the control group and 29 cases in the experiment group.The control group received conventional rehabilitation treatment,while the experiment group received suspension massage exercise techniques in addition to the treatment received in the control group.Before and four weeks after treatment,patients were evaluated with the Postural assessment scale for stroke patients(PASS),the Berg balance scale(BBS),the Fugl-Meyer assessment lower extremity(FMA-LE),and the modified Bar-thel index(MBI).Surface electromyography(sEMG)was used to measure the median frequency(MF)and integrated electromyogra-phy(iEMG)of the patients'bilateral erector spinae and multifissure muscles.Results:Before treatment,there was no statistically significant difference in PASS,BBS,FMA-LE,MBI scores,or bilateral erector spinae and multifidus MF and iEMG values between the two groups(P>0.05).After treatment,both groups showed higher scores of PASS,BBS,FMA-LE,and MBI,as well as MF and iEMG values of the affected erector spinae and multifidus muscles,and MF values of the healthy erector spinae and multifidus mus-cles in the experiment group were higher than those before treatment in the same group(all P<0.05).There were statistically signifi-cant differences in PASS,BBS,FMA-LE,and MBI scores(P<0.05),MF and iEMG values of the affected erector spinae and multifi-dus muscles(P<0.05),and MF values of the healthy erector spinae and multifidus muscles(P<0.05)between the two groups.Corre-lation analysis revealed that the PASS score was positively correlated with the MF value of the affected erector spinae muscle(r=0.404,P=0.030),and the PASS score was posi

关 键 词：脑卒中 悬吊推拿运动技术 姿势控制 姿势控制能力 核心肌群 表面肌电图 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R493[医药卫生—临床医学]