强化患侧下肢负重训练对脑卒中患者平衡与功能性步行能力的影响

关键词：平衡  步行功能  脑卒中  负重  生物反馈

Keywords:balance  walking function  stroke  weight-bearing  biofeedback

摘要：

      目的：探讨强化患侧下肢负重训练对脑卒中偏瘫患者平衡与功能性步行能力的影响。方法：将符合入选标准的脑卒中偏瘫患者随机分为观察组和对照组（各20例）。两组患者均采用常规康复治疗和平衡训练法，在此基础上，观察组加入负重率生物反馈下强化患侧下肢负重的训练方法。以上平衡训练两组均进行30min/d，6d/周，共6周。分别于治疗前、后用Berg平衡量表（BBS）、起立-行走计时测试（TUGT）和改良功能性前伸测试（MFRT）评定平衡与步行功能。结果：6周治疗后，两组的BBS和MFRT值均较治疗前明显提高（P<0.01），TUGT较治疗前缩短（P<0.01）；观察组的BBS、TUGT和MFRT值均优于对照组（P<0.01，P<0.05，P<0.05）。结论：在常规平衡训练基础上，负重率反馈下强化患侧下肢负重的训练能更有效地改善脑卒中偏瘫患者的平衡与功能性步行能力。

Abstract:

      Objective: To study the effect of intensive weight-bearing exercise especially for affected lower limb on balance and walking function in hemiplegic stroke patients. Method: Forty stroke patients were assigned randomly to either an experimental group (20 cases) or a control group (20 cases). Both groups received routine rehabilitation treatment and balance training. In addition, experimental group received intensive weight-bearing exercise especially for affected lower limb with biofeedback of weight-bearing ratio. Balance training was performed in both groups for 30min daily, 6 times a week for 6 weeks. Subjects were assessed with Berg balance Scale (BBS), timed “up & go” test (TUGT) and modified functional reach test(MFRT) before and after 6 weeks of training. Result: After 6 weeks of training, both groups scored higher in BBS and MFRT (P<0.01), and required less time to perform TUGT than before training (P<0.01). Experimental group scored better in the three assessments (BBS、TUGT and MFRT) than control group with significant difference (P<0.01，P<0.05，P<0.05). Conclusion: Intensive weight-bearing exercise especially for affected lower limb was superior to the routine balance training in improving balance and walking function of stroke patients.