镜像阈值负荷训练对改善脑出血偏瘫患者呼吸肌疲劳的效果研究

关键词：镜像疗法  脑出血  呼吸肌疲劳  呼吸肌训练  呼吸功能

Keywords:mirror therapy  cerebral hemorrhage  respiratory muscle fatigue  respiratory muscle training  respiratory function

摘要：

      摘要 目的：观察镜像疗法联合阈值负荷训练对改善脑出血患者呼吸肌疲劳的效果。 方法：于2022年7月—2023年8月选取华北理工大学附属医院脑出血患者168例，采用随机数字表法分为四组，每组42例分别给予常规呼吸训练（对照组）、镜像疗法呼吸训练（镜像组）、阈值负荷训练（阈值组）、镜像阈值负荷训练（联合组），四组患者均给予常规治疗与康复训练。治疗前、治疗2周、4周后，评估患者最大吸气压（maximal inspiratory pressure， MIP）、最大呼气压（maximal expiratory pressure， MEP）、用力肺活量（forced vital capacity， FVC）、呼吸频率（respiration rate， RR）、辅助呼吸肌动用评分情况、疲劳严重度量表（fatigue severity scale， FSS），记录并比较四组患者呼吸肌疲劳改善情况。 结果：治疗前四组患者除FVC基线不平衡，其余指标均无显著性差异（P>0.05）；四组患者治疗2周后，MIP、MEP及FSS评分均有所改善（P<0.05），FVC差值、RR、辅助呼吸肌动用评分差异无显著性意义。治疗4周后，四组患者MIP、MEP、FVC差值、RR、辅助呼吸肌动用评分及FSS评分均较治疗前改善（P<0.05）；联合组MIP、MEP、FVC改善效果最好，阈值组和镜像组次之（P<0.05）；联合组RR、FSS评分均明显低于其他三组（P<0.05）；无辅助呼吸肌过度参与呼吸运动的患者联合组所占比例最高（P<0.05）。 结论：镜像疗法联合阈值负荷训练相较于单一模式呼吸训练方法可以显著改善脑出血患者的呼吸功能和疲劳状况。

Abstract:

      Abstract Objective： To observe the effect of mirror therapy combined with threshold load training on improving respiratory muscle fatigue in patients with cerebral hemorrhage. Method： From July 2022 to August 2023， 168 patients with cerebral hemorrhage from the Affiliated Hospital of North China University of Science and Technology were selected and randomly divided into four groups using a random number table. The patients were divided into four groups （42 cases each）， receiving routine respiratory training （control group）， mirror therapy breathing training （mirror group）， threshold load training （threshold group）， or mirror threshold load training （combination group）. All four groups of patients received routine treatment and rehabilitation training. Patients were evaluated for the maximum inspiratory pressure （MIP）， maximum expiratory pressure （MEP）， forced vital capacity （FVC）， respiratory rate （RR）， auxiliary respiratory muscle mobilization score， and fatigue severity scale （FSS） before treatment，2 weeks， and 4 weeks after treatment. The improvement of respiratory muscle fatigue among the four groups were recorded and compared. Result： Before treatment， there was no statistical difference among the four groups except for the baseline imbalance of FVC （P>0.05）. After 2 weeks of treatment， MIP， MEP and FSS scores of the four groups improved （P<0.05）， while changes in FVC difference， RR， and assisted respiratory muscle mobilisation scores were not statistically significant. After 4 weeks of treatment， MIP， MEP， FVC difference， RR， assisted respiratory muscle movement score and FSS score of the four groups of patients improved compared with the pre-treatment （P<0.05）； the combined group achieved the most significant improvements in MIP， MEP and FVC， followed by the threshold group and the mirroring group （P<0.05）； RR and FSS scores of the combined group were significantly lower than that of the other three groups （P<0.05）； furthermore，the combined group exhibited the highest proportion of patients showing no excessive assisted respiratory muscle involvement in respiratory movements（P<0.05）. Conclusion： Compared with single mode respiratory training， mirror therapy combined with threshold load training can significantly improve the respiratory muscle fatigue of patients with cerebral hemorrhage.