视觉剥夺训练联合本体感觉训练对脑卒中偏瘫患者平衡功能的效果  

Effect of visual deprivation training combined with proprioceptive training on balance in hemiplegic patients after stroke

作　　者：苏盼盼 叶朋 卢倩 何川 陆晓 SU Panpan;YE Peng;LU Qian;HE Chuan;LU Xiao(Rehabilitation Medicine College of Nanjing Medical University,Nanjing,Jiangsu 211166,China;Department of Rehabilitation Medicine,Jiangsu Shengze Hospital,Suzhou,Jiangsu 215228,China)

机构地区：[1]南京医科大学康复医学院,江苏南京市211166 [2]江苏盛泽医院康复医学科,江苏苏州市215228

出　　处：《中国康复理论与实践》2025年第3期254-263,共10页Chinese Journal of Rehabilitation Theory and Practice

基　　金：苏州市科技局医学应用基础研究项目(No.SKY2023033)。

摘　　要：目的 探讨视觉剥夺训练联合本体感觉训练对脑卒中偏瘫患者平衡功能的效果。方法 2022年5月至2024年3月,江苏盛泽医院脑卒中偏瘫患者80例,随机分为对照组(n=20)、本体训练组(n=20)、视觉剥夺组(n=20)和联合组(n=20)。各组均予常规康复训练,本体训练组增加本体感觉训练,视觉剥夺组增加视觉剥夺训练,联合组则增加视觉剥夺训练和本体感觉训练,共4周。治疗前后,采用ProKin平衡测试与训练系统、Berg平衡量表(BBS)、Fugl-Meyer评定量表下肢部分(FMA-LE)、10米步行测试(10MWT)和功能性步态测试(FGA)进行评定。结果 前后和左右平均运动速度组内效应(F> 96.618,P <0.001)和交互效应(F> 5.444,P <0.01)均显著。睁、闭眼运动椭圆面积和运动长度组内效应(F> 177.671,P <0.001)、组间效应(F> 3.761,P <0.05)和交互效应(F>7.555,P<0.001)均显著。10MWT时间,BBS、 FMA-LE和FGA评分组内效应(F>221.902,P<0.001)和交互效应(F> 7.586,P <0.001)均显著;FGA评分组间效应显著(F=5.258,P <0.01)。两两比较显示,联合组和视觉剥夺组各项指标均优于对照组(P <0.05);除睁眼前后、闭眼左右平均运动速度和睁眼运动长度外,本体训练组其他指标均优于对照组(P <0.05);联合组各项指标均优于视觉剥夺组和本体训练组(P <0.05);视觉剥夺组与本体训练组各项指标无显著性差异(P> 0.05)。结论 视觉剥夺训练和本体感觉训练均可有效促进脑卒中偏瘫患者的平衡功能、下肢运动功能和步行能力恢复,联合使用疗效更佳。Objective To explore the effect of visual deprivation training combined with proprioceptive training on balance function of hemiplegic patients after stroke.Methods A total of 80 stroke patients with hemiplegia in Jiangsu Shengze Hospital were selected from May,2022 to March,2024,and randomly divided into control group(n = 20),proprioceptive training group(n = 20),visual deprivation group(n = 20) and combined group(n = 20).All the groups received routine rehabilitation training,while the proprioceptive training group added proprioceptive training,the visual deprivation group added balance training under visual deprivation,and the combined group added visual deprivation training and proprioceptive training,for four weeks.They were assessed with Pro Kin Balance Test and Training System,Berg Balance Scale(BBS),10-metre walking test(10MWT),Fugl-Meyer Assessment-Lower Extremities(FMA-LE) and Functional Gait Assessment(FGA) before and after treatment.Results The intra-group effect(F > 96.618,P < 0.001) and interaction effect(F > 5.444,P < 0.01) were significant in mean longitudinal velocity and mean horizontal velocity.The intra-group effect(F > 177.671,P < 0.001),intergroup effect(F > 3.761,P < 0.05) and interaction effect(F > 7.555,P < 0.001) were significant in movement ellipse area and movement length both with eyes open and closed.The intra-group effect(F > 221.902,P < 0.001) and interaction effect(F > 7.586,P < 0.001) were significant in the time of 10MWT,and the scores of BBS,FMA-LE and FGA;and the inter-group effect were significant in FGA score(F = 5.258,P < 0.01).Post Hoc test showed that all the indicators were better in the combined group and the visual deprivation group than in the control group(P < 0.05);as well as in the proprioceptive training group than in the control group(P < 0.05) except mean longitudinal velocity with eyes open,mean horizontal velocity with eyes closed,and movement length with eyes open;while all the indicators were better in the combined group than both in the visual deprivation g

关 键 词：脑卒中 偏瘫 视觉剥夺 本体感觉训练 平衡 运动 步行 

分 类 号：R743.3[医药卫生—神经病学与精神病学]