血流限制联合运动训练对脑卒中患者下肢功能和步行能力的影响

关键词：血流限制  运动训练  脑卒中  下肢功能  步行能力

Keywords:blood flow restriction  exercise training  stroke  lower extremity  gait function

摘要：

      摘要 目的：探讨血流限制（blood flow restriction，BFR）联合运动训练对脑卒中患者偏瘫侧下肢功能与步行能力的影响。 方法：34例脑卒中患者随机分为BFR联合运动训练组（BRE-ET）（试验组）和运动训练组（ET）（对照组）。患者在每日常规康复基础上，试验组接受运动训练和BFR联合运动训练，对照组接受每日2次运动训练。治疗前、治疗中（10天）、治疗后（20天）采用Brunnstrom分期、肌力（MMT）、肌张力（MAS）、主动关节活动度（AROM）、Fugl-Meyer评定量表-下肢部分（FMA-LE）、“起立-行走”计时测试（TUGT）、改良Barthel指数（MBI）对两组患者进行3次评估。 结果：治疗20天后，两组偏瘫侧踝跖屈AROM与髋外展肌力与治疗前有明显改善（P<0.001），且试验组明显优于对照组（P=0.014；P=0.048）。两组FMA-LE、TUGT、MBI治疗前后均有明显改善（P<0.001）。治疗后试验组TUGT与治疗中相比差异有显著性意义（P=0.002）。 结论：BFR结合运动训练较常规运动训练能更有效的改善脑卒中患者下肢功能，对步行功能、日常生活活动能力有更好临床治疗效果的发展趋势。

Abstract:

      Abstract Objective： To investigate the effect of blood flow restriction combined with exercise training on hemiplegic lower extremity and gait function in stroke patients. Method： Totally 34 stroke patients were randomly divided into blood flow restriction combined with exercise training （BFR-ET） group and exercise training （ET） group. During 20-day trial period， experiment group received 20-minute BFR-ET and 30-minute ET per day， while control group received 30-minute ET twice per day. Pre-， mid- and after-treatment， they were evaluated with Brunnstrom Stage， manual muscle test （MMT）， Modified Ashworth scale （MAS）， Active range of motion （AROM）， Fugl-Meyer assessment-lower extremities （FMA-LE）， Time-up and Go Test （TUGT） and modified Barthel index （MBI）. Result： There were greater improvements of ankle plantar flexion （P=0.014） and strength of hip abduction （P=0.048） of hemiplegic lower extremity in BFR-ET group than in ET group. The scores of FMA-LE、TUGT、MBI were markedly increased in all groups after treatment （P<0.001）. The result of TUGT showed a significantly statistical difference between mid-treatment and after-treatment in BFR-ET group （P=0.002）. Conclusion： Blood flow restriction combined with exercise training can improve lower extremity function than exercise training separately. There is a potential tendency of BFR-ET for increasing gait function and daily-living ability of stroke patients.