运动双任务训练对慢性脑卒中患者平衡功能的影响

关键词：脑卒中  平衡  运动双任务

Keywords:chronic stroke  balance  motor dual task

摘要：

      摘要 目的：观察运动双任务训练对慢性脑卒中患者平衡功能的康复效果。 方法：选取有平衡功能障碍的慢性脑卒中患者31例，在基线评估后，随机分为试验组（n=17）和对照组（n=14）。试验组采用常规康复治疗方法结合运动双任务训练，对照组采用常规康复治疗方法。两组治疗每次45min，每周5次，共干预6周。运用5次坐站试验（five times sit-to stand test，FTSST）、起立-行走计时测试（time up and go test，TUGT）和平衡测试仪测动静态平衡能力；运用 Berg 平衡量表（Berg balance scale，BBS）评估跌倒风险；运用10m步行速度测试（10-meter walking test，T10）评估步行速度；运用Barthel指数量表（Barthel index，BI）评估日常生活活动能力；运用双任务消耗（dual task cost，DTC）来评估单双任务下各项指标的相对变化值以量化双任务干扰程度。 结果：在治疗前，试验组和对照组各项数据相比差异无显著性意义，经过6周试验干预后，与治疗前相比，两组Berg评分及DTC指标显著提高，差异有显著性意义（P＜0.05）；2组FTSST、单任务下重心移动轨迹长度、T10及TUGT显著下降，差异有显著性意义（P＜0.05）；治疗后，两组Berg评分、DTC指标、FTSST和单任务下重心移动轨迹长度、T10及TUGT比较均有显著性意义（P＜0.05），Barthel指数评分无显著性意义（P＞0.05），试验组双任务下重心移动轨迹长度、T10、TUGT及DTC与对照组相比均有显著性意义（P＜0.05）。 结论：运动双任务训练可以有效改善慢性脑卒中患者在单任务和双任务条件下的平衡功能障碍。

Abstract:

      Abstract objective：To observe the rehabilitation effect of exercise dual task training on balance function in patients with chronic stroke. Method：Thirty-one patients with chronic stroke with balance dysfunction were randomly divided into experimental group (n=17) and control group (n=14) after baseline evaluation. The experimental group was treated with conventional rehabilitation therapy combined with exercise double task training， while the control group was treated with conventional rehabilitation therapy. The two groups were treated for 45 minutes， 5 times a week， for a total of 6 weeks. Five times sit-to-stand test (FTSST)， Time Up and Go Test (TUGT) and balance tester were used to measure the dynamic and static balance ability. Berg Balance Scale (BBS) was used to assess fall risk. The 10-meter walking test (T10) was used to assess walking speed. Barthel index (BI) was used to evaluate the ability of daily living activities. The dual task cost (DTC) was used to evaluate the relative change of each index under the single or dual task to quantify the interference degree of dual task. Result：Before treatment， there was no statistically significant difference between the experimental group and the control group. After 6 weeks of experimental intervention， Berg score and DTC indexes in the two groups were significantly improved compared with those before treatment， and the difference was statistically significant (P<0.05). The trajectory length， T10 and TUGT of center of gravity under single task significantly decreased in the two groups (P<0.05). After treatment， Berg score， DTC indicators， FTSST and single task under the center of gravity moving trajectory length， T10 and TUGT had statistical significance for two groups(P<0.05)， while the Barthel index score had no statistical significance (P>0.05). The under dual task barycenter moving trajectory length， T10， TUGT and DTC in the experimental group had statistical significance when compared with those in the control group (P<0.05). Conclusion：Exercise dual task training can effectively ameliorate the balance dysfunction of patients with chronic stroke under the condition of single task and dual task.