综合呼吸训练对脑卒中偏瘫患者平衡及运动功能的影响

关键词：呼吸肌训练  脑卒中  平衡功能  运动功能

Keywords:respiratory muscle training  stroke  balance function  motor function

摘要：

      摘要 目的：观察综合呼吸训练结合常规康复训练对脑卒中偏瘫患者静、动态平衡及运动功能的影响。 方法：共有28例脑卒中患者纳入本研究，其中男性15例，女性13例，采用随机数字表法将其分为试验组(14例)及对照组(14例)。两组患者均接受常规康复治疗，试验组在此基础上进行综合呼吸训练，包括常规呼吸训练及应用Power Breath KH2便携式肺功能检测与训练仪进行渐进抗阻吸气肌力量训练。两组分别在治疗前、治疗8周应用荷兰STABLE三维平衡姿势控制训练与评估系统评估姿势稳定性和稳定时间，应用Berg平衡量表评估平衡功能，应用Fugl-Meyer运动功能评分(Fugl-Meyer assessment，FMA)量表下肢部分评价患者下肢运动功能，应用Power Breath KH2便携式肺功能检测与训练仪评估最大吸气压(maximum inspiratory pressure，MIP)和吸气流速峰值(peak inspiratory flow，PIF)。 结果：治疗8周后，两组患者下肢FMA、BBS评分均较治疗前明显提高(P<0.01)，且试验组明显高于对照组(P<0.01)。治疗后，两组在睁眼站立、闭眼站立、脚一前一后站立时的重心移动速度及稳定时间较治疗前显著降低(P<0.01，P<0.05)，且试验组较对照组各项静动态平衡指标改善更为显著(P<0.01)。两组在治疗后MIP、PIF值与治疗前比较显著改善(P<0.05，P<0.01)。治疗后试验组MIP、PIF值与对照组相比改善更为显著(P<0.05，P<0.01)。 结论：综合呼吸训练结合常规康复训练可以更有效改善脑卒中患者静态及动态平衡功能，提高下肢运动能力。

Abstract:

      Abstract Objective： To observe effects of comprehensive breathing training on static and dynamic balance and motor function of stroke patients with hemiplegia. Method： A total of 28 stroke patients were included in the study， including 15 males and 13 females. They were divided into the experimental group (14 cases) and the control group (14 cases) by the method of random number table. Both groups received routine physical therapy. On this basis， the experimental group received comprehensive respiratory training， including routine respiratory training and progressive resistance inspiratory muscle strength training with Power Breath KH2 portable lung function test and training instrument. Clinical outcomes were evaluated before treatment and8 weeks after treatment. Postural Stability and Time to Stability were measured by Dutch STABLE three-dimensional balanced posture control training and evaluation system. Berg Balance Scale (BBS) was used to evaluate the balance function. Fugl-Meyer Assessment (FMA) was used to evaluate the lower limb motor function of patients. Maximum inspiratory pressure (MIP) and peak inspiratory flow (PIF) were assessed by Power Breath KH2 portable lung function test and training instrument. Result： After 8 weeks of treatment， the scores of FMA and BBS were significantly higher than those before treatment (P<0.01)， and the scores in the experimental group were significantly higher than those in the control group (P<0.01). After treatment， the time to stability and the average center of pressure (COP) velocity when standing with eyes open， closed eyes and one foot in front was significantly lower than that before treatment(P<0.01，P<0.05)， the static and dynamic balance indexes of the experimental group were improved more significantly than those of the control group(P<0.01). Conclusion： Comprehensive breathing training can effectively improve the static and dynamic balance function and the motor function of lower limbs of stroke patients.