MOTOmed智能训练系统联合减重步态训练改善脑卒中偏瘫患者偏瘫步态研究  

Clinical Study of MOTOmed Intelligent Training System Combined with Weight Support Gait Training on Improving Hemiplegic Gait of Stroke Patients with Hemiplegia

作　　者：李娜 梁雪琴 潘芳芳 段亚男 张香玉 LI Na;LIANG Xueqin;PAN Fangfang;DUAN Yanan;ZHANG Xiangyu(Cangzhou People's Hospital,Cangzhou,Hebei 061000,China)

机构地区：[1]沧州市人民医院,河北沧州061000

出　　处：《康复学报》2024年第3期288-293,共6页Rehabilitation Medicine

基　　金：沧州市重点研发计划指导项目(213106078)。

摘　　要：目的观察MOTOmed智能训练系统联合减重步态训练对脑卒中偏瘫患者伸肌协同偏瘫步态的运动学影响。方法收集2021年12月—2022年12月在沧州市人民医院住院治疗的脑卒中偏瘫患者共90例,并按照随机数字表法将其分为MOTOmed智能训练系统组(对照组)以及MOTOmed智能训练系统联合减重步态训练组(试验组),每组45例。2组均采用常规康复治疗,辅以MOTOmed智能系统训练,包括利用MOTOmed智能系统的下肢环转运动训练和主动模式进行抗阻力训练。试验组增加减重步态训练,减小重量从体质量的30%开始,根据患者身体情况酌量减少至体质量15%水平,或完全负重,平板运行速度为0.2~1.0 m/s。2组在治疗前及治疗4周后进行康复评估,应用Barthel指数评定量表、Holden步行功能评定、偏瘫步态分析评价量表、下肢运动功能评估(FMA-LE)及平衡功能评估(BBS),比较2组的康复治疗效果。结果与组内治疗前比较,2组治疗4周后Barthel指数评定量表评分、Holden步行功能分级、偏瘫步态分析均有所改善(P<0.05)。与对照组相比较,试验组治疗4周后Barthel指数评定提高(P<0.05),患侧支撑期百分比、步速、步频和步长增大(P>0.05),双支撑期百分比减少(P<0.05),Holden步行功能分级改善(P<0.05),FMA-LE和BBS评分增加(P<0.05)。结论MOTOmed智能训练系统联合减重步态训练可有效地改善脑卒中伸肌协同偏瘫患者的步态及步行的能力。Objective To observe the kinematic effects of MOTOmed intelligent training system combined with weight sup‐port gait training on extensor synergistic hemiplegic gait in stroke patients with hemiplegia.Methods A total of 90 stroke patients with hemiplegia who were hospitalized in Cangzhou People's Hospital from December 2021 to December 2022 were recruited and randomly divided into MOTOmed intelligent training group(control group)and MOTOmed intelligent training system combined with weight-support gait training group(experimental group),with 45 patients in each group.Both groups were treated with routine rehabilitation,supplemented by MOTOmed intelligent training system,including lower limb circumduction exercise training and active mode resistance training.Weight support gait training was added to the experimental group.Weight reduction started from 30%of the body weight,and was reduced to 15%of the body weight or fully weight bearing,according to the patient's physical con‐dition,and the treadmill walking speed was set as 0.2-1.0 m/s.The patients in the two groups were evaluated before and after 4 weeks of treatment.The rehabilitation outcomes of the two groups were compared by using Barthel index,Holden walking function assessment,hemiplegic gait analysis rating scale,Fugl-Meyer assessment lower extremity(FMA-LE)and Berg balance scale(BBS).Results After 4 weeks of treatment,both groups showed improvements in Barthel Index score,Holden walking function classifica‐tion,and hemiplegic gait analysis results(P<0.05).Compared with the control group,after 4 weeks of treatment,the Barthel index score of the experimental group increased(P<0.05),the percentage of single support period,step speed,step frequency and step length of the affected side increased,and the percentage of double support period decreased(P<0.05).Compared with those in the group before treatment,the scores of Barthel index,Holden walking function classification,and hemiplegic gait analysis in the two groups improved after treatment(P<0.05).The

关 键 词：偏瘫 脑卒中 减重步态训练 下肢功能 MOTOmed智能训练 

分 类 号：R743.3[医药卫生—神经病学与精神病学]