不稳定支撑面训练对慢性卒中患者平衡和步态的影响  

Effects of Unstable Support Surface Training on Balance and Gait in Patients with Chronic Stroke

作　　者：刘姣 孟庆华[1,2,3] 周鲁星 黄旭 阎峰[1] 徐倩漪[1] 刘文红 李猛 薛艳艳 LIU Jiao;MENG Qinghua;ZHOU Luxing;HUANG Xu;YAN Feng;XU Qianyi;LIU Wenhong;LI Meng;XUE Yanyan(School of Sports Economics and Management,Tianjin University of Physical Education,Tianjin 301617,China;Tianjin Key Laboratory of Sports Physiology and Sports Medicine,Tianjin University of Physical Education,Tianjin 301617,China;Tianjin Virtual Simulation Teaching Center of Sports Injury and Rehabilitation,Tianjin University of Physical Education,Tianjin 301617,China;Tianjin Rehabilitation and Sanatorium Center,Tianjin 301617,China)

机构地区：[1]天津体育学院体育经济与管理学院,天津301617 [2]天津体育学院天津市运动生理与运动医学重点实验室,天津301617 [3]天津体育学院天津市运动损伤与康复虚拟仿真教学中心,天津301617 [4]天津康复疗养中心,天津301617

出　　处：《医用生物力学》2022年第6期1145-1150,共6页Journal of Medical Biomechanics

基　　金：国家自然科学基金项目(11372223,11102135);天津市自然科学基金项目(17JCZDJC36000,18JCZDJC35900);天津市研究生科研创新项目(2021YJSS312)。

摘　　要：目的 探讨不稳定支撑面(unstable support surface, USS)训练对慢性脑卒中患者平衡、步态和下肢运动功能的影响。方法 将20名卒中患者分为两组,对照组(n=10)在常规治疗基础上进行12周常规康复训练,实验组(n=10)在常规治疗的基础上进行12周平衡板训练。使用BBS量表、Fugl-Meyer下肢功能量表、10 m步行速度测试(10 MWT)、6 min步行距离测试(6 MWD)评估患者干预前后动态平衡、步行和下肢运动功能;利用NeuroCom Balance Manager系统、Qualisys三维动作捕捉与分析系统和Kistler三维测力台测量患者干预前后静态平衡和运动学、动力学步态数据。结果 干预后,两组之间及实验组组间BBS评分、Fugl-Meyer评分、6 MWD评分结果差异具有统计学意义(P<0.05),实验组组间10 MWT评分具有统计学意义(P<0.05)。干预后,两组之间及实验组组间两侧负重/下蹲在90°和60°时差异具有统计学意义(P<0.05),实验组组间负重/下蹲在30°和0°时差异具有统计学意义(P<0.05)。干预后,两组组间压力中心对称性和髋关节对称性差异具有统计学意义(P<0.05),膝、踝关节对称性差异无统计学意义(P>0.05)。结论 利用NeuroCom Balance Manager系统的平衡板进行USS训练能有效改善脑卒中患者平衡、步态和下肢运动功能。Objective To investigate the effects of unstable support surface(USS) training on balance, gait and lower limb motor function in patients with chronic stroke. Methods Twenty stroke patients were divided into two groups. Control group(n=10) received 12 weeks of routine rehabilitation training on the basis of conventional treatment, and experimental group(n=10) received 12 weeks of balance plate training on the basis of conventional treatment. BBS scale, Fugl-Meyer lower limb function scale, 10-meter walking speed test(10 MWT)and 6-minute walking distance test(6 MWD)were used to evaluate dynamic balance, walking and lower limb motor function before and after intervention.NeuroCom Balance Manager system, Qualisys 3D motion capture and analysis system and Kistler 3D force platform were used to measure the patient’s static balance, as well as their kinematics and dynamic gait data before and after intervention. Results After intervention, the differences in BBS score, Fugl-Meyer score and 6 MWD score between control group and experimental group as well as between experimental groups had statistical significance(P<0.05), and the difference in 10 MWT score between experimental groups was statistically significant(P<0.05). After intervention, the difference in weigh-bearing/squat(WB/S) between control group and experimental group as well as between experimental groups at 90° and 60° had statistical significance(P<0.05), and the difference in WB/S between experimental groups at 30° and 0° was statistical significant(P<0.05).After intervention, the differences in center of pressure(COP) symmetry and hip joint symmetry between control group and experimental group had statistical significance(P<0.05), while the difference in symmetry of knee joint and ankle joint was not statistically significant(P>0.05). Conclusions USS training with NeuroCom Balance Manager Balance board can effectively improve balance, gait and lower limb motor function in stroke patients.

关 键 词：脑卒中 核心稳定性 不稳定支撑面 平衡 下肢 步态功能 

分 类 号：R318.01[医药卫生—生物医学工程]