凝视稳定训练对脑卒中偏瘫患者平衡功能和下肢运动功能的影响  

Effect of gaze stabilization training on balance function and lower extremity motor function in hemiplegic patients with stroke

作　　者：程攀 王本国 李威[2] 郑杰 秦艳霞 李创国 孟庆天 Cheng Pan;Wang Benguo;Li Wei(Department of Rehabilitation Medicine,the Second Affiliated Hospital,School of Medicine,the Chinese University of Hong Kong,Shenzhen&Longgang District People’s Hospital of Shenzhen,Shenzhen 518172,China)

机构地区：[1]香港中文大学(深圳)附属第二医院&深圳市龙岗区人民医院康复医学科,深圳518172 [2]自贡市第一人民医院康复医学科,四川自贡643000

出　　处：《中国康复》2024年第5期264-268,共5页Chinese Journal of Rehabilitation

基　　金：深圳市龙岗区经济与科技发展专项资金医疗卫生科技计划项目(LGKCYCWS2020059)。

摘　　要：目的:观察凝视稳定训练对脑卒中偏瘫患者平衡功能和下肢运动功能的疗效。方法:将58例脑卒中偏瘫患者随机分为观察组和对照组各29例。对照组给予常规康复训练,观察组在此基础上加用凝视稳定训练。治疗前和治疗6周后分别采用Berg平衡量表(BBS)评定静态和动态平衡功能,动态步态指数(DGI)评定动态平衡功能,Balance-B平衡评定与训练系统评定静态平衡功能和跌倒风险,Fugl-Meyer运动评分量表中下肢部分(FMA-LE)评定下肢运动功能,Holden步行功能分级(FAC)评定步行功能,改良Barthel指数(MBI)评定日常生活活动(ADL)能力。结果:治疗6周后,2组患者BBS、DGI、FMA-LE、FAC和MBI均较治疗前显著提高(P<0.01),且观察组均更高于对照组(P<0.01,0.05);2组患者X轴和Y轴重心偏移、X轴和Y轴重心移动平均速度、重心移动总轨迹长和跌倒风险系数均较治疗前显著下降(P<0.01),且观察组均更低于对照组(P<0.01,0.05)。结论:凝视稳定训练能有效改善脑卒中偏瘫患者静态和动态平衡功能,降低跌倒风险,提高下肢运动功能、步行功能和ADL能力。Objective:To observe the effect of gaze stabilization training on balance function and lower extremity motor function in hemiplegic patients with stroke.Methods:A total of 58 stroke patients were randomly divided into an observation group(n=29)and a control group(n=29).Two groups were given conventional rehabilitation training,and the observation group received gaze stabilization training additionally.Berg Balance Scale(BBS)for static and dynamic balance function,dynamic gait index(DGI)for dynamic balance function,balance-B balance assessment and training system for static balance function and fall risk,Fugl-Meyer motor assessment(FMA-LE)for the lower extremity,functional ambulation classification(FAC)for walking function and modified Barthel index(MBI)for activities of daily living(ADL)were evaluated at the beginning and at the end of the 6th week of treatment course respectively.Results:After treatment of 6 weeks,BBS,DGI,FMA-LE,FAC and MBI were significantly improved as compared with those pre-treatment in both groups after treatment(P<0.01),and those in the observation group were higher than in the control group(P<0.01,0.05);X-axis and Y-axis center of gravity deviation,average velocity of X-axis and Y-axis center of gravity movement,total trajectory length of center of gravity movement and fall risk coefficient significantly decreased compared to those before treatment(P<0.01),and those in the observation group were lower than in the control group(P<0.01,0.05).Conclusion:Gaze stabilization training in the treatment for stroke patients can improve the static and dynamic balance function,reduce the fall risk,improve the motor function of lower extremity,walking function and activities of daily living.

关 键 词：凝视稳定训练 前庭训练 脑卒中 平衡功能 下肢运动功能 

分 类 号：R49[医药卫生—康复医学] R743.3[医药卫生—临床医学]