| 孙良文,胡锦荣,潘喆,叶素贞,李海燕,周成业.基于现实环境的功能性步态训练对卒中偏瘫患者早期社区生活的影响[J].中国康复,2017,32(3):260-263 |
| 基于现实环境的功能性步态训练对卒中偏瘫患者早期社区生活的影响 |
| Effects of the functional gait training based on the realistic environment on the early community life of the stroke patients with hemiplegia |
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| DOI： |
| 中文关键词: 脑卒中 现实环境 功能性步态训练 平衡反应 跌倒 日常生活活动能力 |
| 英文关键词: stroke realistic environment functional gait training (FGT) balance response fall activities of daily living (ADL) |
| 基金项目:温州市科技计划资助项目（Y20150027） |
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| 中文摘要: |
| 目的：探讨在现实环境中采用功能性步态训练（FGT）以强化恢复期卒中偏瘫患者的平衡反应及姿势控制能力对其早期社区生活活动能力及平衡信心的影响，以及对活动中跌倒事件的预防作用。方法：将32例卒中恢复期患者随机分为观察组（16例）及对照组（16例）。对照组采用常规康复训练，观察组在此基础上增加现实环境中的功能性步态训练。训练前、训练6周及出院后第3个月采用特异性活动平衡信心量表（ABC）分别评估参与者的活动平衡信心。出院后第3个月采用功能活动调查表（FAQ）评估社区生活工具性日常生活活动能力，收集跌倒相关数据。结果：训练6周后，2组ABC评分均较治疗前明显提高（均P<0.01），且观察组优于对照组（P<0.01）。随访3个月，2组跌倒总人数和跌倒总次数组间比较差异无统计学意义；2组患者中跌倒者均未造成严重损伤，损伤程度比较差异无统计学意义；但FAQ及ABC评分比较，组间差异有统计学意义（均P<0.05）；患者中社区生活发生跌倒者的FAQ评分明显高于非跌倒者（P<0.05），ABC评分明显低于非跌倒者（P<0.05）。结论：结合常规康复训练，在现实环境中强化平衡反应及姿势控制能力的功能性步态训练方案，有利于提高卒中偏瘫患者的平衡信心，对社区生活活动能力有积极影响。 |
| 英文摘要: |
| Objective: To investigate the effects of the functional gait training (FGT) in the realistic environment to improve balance response and postural control ability on the activities of daily living (ADL) and the quality of life in the convalescent stroke patients with hemiplegia in the early community life, as well as the preventive effects of the fall events after discharge. Methods: Thirty two hemiplegic patients after stroke in the convalescent stage met the inclusion criteria, and were randomly divided into control group (16 cases) and experimental group (16 cases). Both the control group and the experimental group received routine rehabilitation training in the therapeutic rooms, 60 min per day, 5 days a week for 6 weeks. In addition, the experimental group was given the FGT in the realistic environment outside of the rehabilitation zone, 60 min per day, 5 days a week for 6 weeks. In all the patients the balance confidence was evaluated with the specific activity balance confidence scale (ABC) before, after 6 weeks of training, and in the third month of community life respectively; the instrumental activities of daily living (IADL) were assessed with functional activity questionnaire (FAQ) once a month for three months after discharge. All patients were followed up with phone or outpatient every month after discharge at least for three months, to collect the fall relevant data. Results: The ABC scores in both groups before training showed no significant difference (P>0.05). After six weeks of training, the scores were significantly increased as compared with those before training (P<0.01). As compared with the control group, the ABC scores in the experimental group were significantly increased (P<0.05), and the development results of the ABC were statistically significant (P<0.05). The follow-up fall related data had no significant difference between the two groups (P>0.05). The average FAQ scores were significantly lower and the ABC average scores were significantly higher in the experimental group than in the control group (P<0.05), and the ABC scores in patients with a fall were significantly lower and the FAQ scores were significantly higher (P<0.05). Conclusion: Combined with the rehabilitation in the therapeutic rooms, the FGT in the realistic environment to improve balance response and postural control ability is more effective to improve the balance confidence of stroke patients with hemiplegia, and has a positive effect on the activities of life in the community. |
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