脑卒中后平衡功能障碍对下肢功能及步态的影响研究  

Effect of balance dysfunction on lower limb function and gait after stroke

作　　者：赵欣桐 郑羿婕 张亚茹 张群[1] 张颖 王春方[1] ZHAO Xintong;ZHENG Yijie;ZHANG Yaru;ZHANG Qun;ZHANG Ying;WANG Chunfang(Department of Rehabilitation Medical,Tianjin Union Medical CentreTianjin Institute of Rehabilitation,Tianjin300121,China;School of Sports and Health,Tianjin University of Sport,Tianjin301617,China;Tianjin Key Specialty of Spinal Rehabilitation with Integrated Traditional Chinese and Western Medicine,Tianjin300121,China)

机构地区：[1]天津市人民医院康复医学科天津市康复医学研究所,天津300121 [2]天津体育学院运动健康学院,天津301617 [3]天津市中西医结合脊柱康复重点专科,天津300121

出　　处：《中国医药导报》2024年第35期104-108,共5页China Medical Herald

基　　金：国家自然科学基金资助项目(82102652);天津市科技计划项目(22JCZDJC00060);天津市卫生健康科技项目青年人才项目(TJWJQN020)。

摘　　要：目的 探究脑卒中后平衡功能障碍对下肢功能及步态的影响。方法 选取2022年3月至2023年12月就诊于天津市人民医院60例脑卒中患者为研究对象。所有患者依据《中国脑卒中康复治疗指南(2011完全版)》进行康复治疗,30 min/次,每周6次,治疗4周。比较治疗前后患者Fugl-Meyer评定量表下肢部分(FMA-LE)评分、起立-行走计时测试(TUGT)、空间步态对称率(SGS)、时间步态对称率(TGS)、Berg平衡量表(BBS)评分及测试执行时间(TTE);分析下肢功能、步态及平衡功能的相关性。结果 55例脑卒中患者完成了本研究。治疗后,FMA-LE评分、步速、BBS评分高于治疗前,TUGT、TTE短于治疗前,SGS、TGS低于治疗前(P<0.05)。治疗前,BBS评分与FMA-LE评分、步速呈正相关(r>0,P<0.01),与TUGT呈负相关(r<0,P<0.01);TTE与步速呈负相关(r<0,P<0.05)。BBS评分变化与FMA-LE评分变化呈正相关(r>0,P<0.01),与TUGT变化呈负相关(r<0,P<0.01);TTE变化与FMA-LE评分、步速变化呈负相关(r<0,P<0.05),与TUGT、SGS变化呈正相关(r>0,P<0.05)。治疗前BBS评分与TUGT变化呈正相关(r>0,P<0.05);治疗前TTE与FMA-LE评分变化呈正相关(r>0,P<0.01),与SGS变化呈负相关(r<0,P<0.01)。结论 脑卒中早期平衡功能受损与下肢功能、步速受损有关,且平衡功能的改善与下肢功能、步速、步态空间对称性的改善有关。Objective To explore the effect of balance dysfunction on lower limb function and gait after stroke.Methods A total of 60 stroke patients admitted to Tianjin Union Medical Centre from March 2022 to December 2023 were selected as the study objects.All patients received rehabilitation treatment according to the Chinese Stroke Rehabilitation Treatment Guidelines(2011 Complete Edition),30 min/time,6 times a week for 4 weeks.The Fugl-Meyer assessment-lower extremity(FMA-LE)score and timed up and go test(TUGT),spatial gait symmetry(SGS),temporal gait symmetry(TGS),Berg balance scale(BBS)score,and test time execution(TTE)were compared before and after treatment;the correlation between lower limb function,gait,and balance function were analyzed.Results Fifty-five patients with stroke completed the study.After treatment,FMA-LE score,walking speed,and BBS score were higher than before treatment,TUGT and TTE were shorter than before treatment,SGS and TGS were lower than before treatment(P<0.05).Before treatment,BBS score was positively correlated with FMA-LE score and walking speed(r>0,P<0.01),and negatively correlated with TUGT(r<0,P<0.01);TTE was negatively correlated with walking speed(r<0,P<0.05).BBS score change was positively correlated with FMA-LE score change(r>0,P<0.01),and negatively correlated with TUGT change(r<0,P<0.01);TTE change was negatively correlated with FMA-LE score and pace changes(r<0,P<0.05),and positively correlated with TUGT and SGS changes(r>0,P<0.05).There was a positive correlation between BBS score before treatment and TUGT change(r>0,P<0.05);TTE before treatment was positively correlated with FMA-LE score change(r>0,P<0.01)and negatively correlated with SGS score change(r<0,P<0.01).Conclusion Impaired balance function in the early stages of stroke is related to the impaired lower limb function and walking speed,and the improvement of balance function is related to the improvement of lower limb function,walking speed,and spatial symmetry of gait.

关 键 词：脑卒中 下肢功能障碍 平衡 步态 

分 类 号：R493[医药卫生—康复医学]