天轨悬吊训练对脑卒中偏瘫患者肌肉厚度、平衡和步行能力的影响

关键词：脑卒中  天轨悬吊  肌肉厚度  平衡功能  肌骨超声

Keywords:stroke  orbital suspension  muscle thickness  balance function  myoseletous ultrasound

摘要：

      摘要 目的：探讨天轨悬吊训练对脑卒中偏瘫患者肌肉厚度、平衡和步行能力的影响。 方法：2023年10月至2025年1月，选择Holden步行功能分级≥1级且＜3级的脑卒中偏瘫患者40例，随机分为治疗组和对照组各20例。两组均接受常规物理治疗，治疗组于此基础上采用天轨悬吊训练，共4周。治疗前后采用Berg平衡量表（Berg balance scale test，BBS）、Holden步行功能分级进行疗效评定，采用肌骨超声测量双侧腹肌、股直肌、胫前肌、股二头肌长头、腓肠肌内侧头厚度。 结果：治疗后两组两侧腹外斜肌厚度、患侧股直肌厚度、BBS评分和Holden步行功能分级评分均改善（P＜0.05）。治疗组两侧腹外斜肌、患侧腹内斜肌、患侧股直肌、健侧胫前肌厚度、患侧股直肌厚度与股二头肌长头厚度比较对照组改善（P＜0.05）。两组患侧股直肌厚度差值与BBS评分差值有中等相关（r：0.592，0.552）。治疗组腹外斜肌、健侧胫前肌厚度差值与BBS评分差值有关（r：0.467，0.592）；对照组双侧腹横肌厚度差值与BBS评分差值有关（r：0.581，0.499）。 结论：天轨悬吊训练有效改善平衡、步行功能。可改善双侧腹外斜肌厚度、患侧股直肌厚度、健侧胫前肌厚度、双侧股直肌厚度与股二头肌厚度比。股直肌厚度变化与平衡功能改善有关。

Abstract:

      Abstract Objective：To investigate the effect of orbital suspension training on muscle thickness， balance and walking ability in stroke patients with hemiplegia. Method： From October 2023 to January 2025，40 stroke patients with hemiplegia, having a Holden walking function grade of ≥1 and <3 were randomly divided into a treatment group and a control group， with 20 patients in each group. Both groups received conventional physiotherapy， while the treatment group was received orbital suspension training on this basis for 4 weeks. The Berg balance scale （BBS） and Holden walking function grading were used for efficacy evaluation before and after treatment. Muscle thickness of the bilateral abdominal muscle thickness， rectus femoral， tibialis anterior， biceps long head， and medial head thickness of gastrocnemius was measured using musculoskeletal ultrasound. Result： After treatment， the thickness of the external oblique muscles on both sides， the thickness of the rectus femoris muscle on the affected side， BBS score， and Holden walking function grading score improved in both groups（P＜0.05）. The treatment group showed significant improvement compared to the control group in the thickness of the external oblique muscles on both sides， the internal oblique muscle on the affected side， the rectus femoris muscle on the affected side， the tibialis anterior muscle on the unaffected side， and the thickness of rectus femoris muscle to the long head of the biceps femoris muscle （P<0.05）. There was a moderate correlation between the difference in thickness of the rectus femoris muscle and the BBS score in both two groups（r：0.592，0.552）. In the treatment group, the difference in thickness between the external oblique muscle and the healthy anterior tibialis muscle was related to the difference in BBS score（r：0.467，0.592）. In the control group, the difference in thickness both the bilateral transverse abdominis muscles was related to the difference in BBS scores（r：0.581，0.499）. Conclusion：Orbital suspension training can effectively improve balance and walking function. It also enhances the thickness of bilateral lateral oblique muscle， rectus femoris on the affected side， tibialis anterior muscle and thickness ratio of the rectus femoris to the biceps femoris on both sides. The change in thickness of rectus femoris muscle is related to the improvement of balance function.