节律性听觉刺激同步膝关节控制训练对脑卒中患者步行能力的影响  

作　　者：谢雨晴 程瑞动[2] 金振华[2] 叶祥明[2] 

机构地区：[1]浙江中医药大学,310053 [2]浙江省人民医院(杭州医学院附属人民医院),310014

出　　处：《浙江临床医学》2024年第10期1469-1472,共4页Zhejiang Clinical Medical Journal

基　　金：浙江省医药卫生科技计划项目(2021KY538)。

摘　　要：目的探讨节律性听觉刺激同步膝关节控制训练对脑卒中患者下肢步行能力的影响。方法选取2021年1月至2022年1月浙江省人民医院康复医学科脑卒中偏瘫患者50例,采用随机数字表法将患者分为观察组与对照组,每组各25例。对照组采取常规步行训练,观察组运用节律性听觉刺激软件控制节奏并加强膝关节控制训练,分别在训练前、训练后2周,训练后4周对患者Fugl-Meyer运动功能评定量表下肢部分(FMA-LE)、Berg平衡评分量表(BBS)、10米最大速度(10 MWT)、生活质量综合评定问卷(GQOLI-74)、改良Barthel指数量表(MBI)、股直肌、腘绳肌、胫前肌、腓肠肌肌腹四块肌肉表面肌电图(sEMG)的RMS值进行评分及疗效分析。结果治疗后,两组FMALE评分、BBS评分、10MWT、GQOLI-74评分、sEMG、MBI分值均明显改善,差异有统计学意义(P<0.001),观察组各项成绩均优于对照组(P<0.05)。结论节律性听觉刺激同步膝关节控制训练能改善脑卒中患者下肢步行能力及下肢相关自理能力。Objective To explore the effect of rhythmic auditory stimulation with knee control training on lower limb walking ability in stroke patients.Methods 50 patients with stroke hemiplegia treated in the rehabilitation department of our hospital from January 2021 to January 2022 were randomly divided into 25 groups of the observation group and 25 groups in the control group.The control group was given routine walking training.The observation group used the rhythmic auditory stimulation software to control the rhythm and strengthen the knee joint control training.Before training,2weeks after training and 4 weeks after training,patients were also scored and efficacied analysis with h Fugl-Meyer As-sessment-Lower Extremities(FMA-LE),Berg balance assessment(BBS),Maximum speed of 10 m(10 MWT),quality of life assessment questionnaire(GQOLI-74),modified Barthel Index(MBI)and the root mean square(RMS)of surface electromyography(sEMG)of four muscles of rectus femoris,hamstring,tibialis anterior,and gastrocnemius.Results After both treatment groups,the FMA-LE,BBS,10 MWT,GQOLI-74 scores,sEMG and MBI scores improved significantly(P<0.001),and the observation group was better than the control group(P<0.05).Conclusion Rhythmic auditory stimulation with synchronized knee control training can improve the lower limb walking ability and lower limb related self-care ability.

关 键 词：脑卒中 节律性听觉刺激 膝关节控制训练 下肢步行能力 

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]