文章摘要
吴晓强,张晓玲,官俏兵,王琰萍,徐从英.帕金森病患者康复训练后步态改善及其与疼痛的相关性分析[J].中国康复,2018,33(2):98-101
帕金森病患者康复训练后步态改善及其与疼痛的相关性分析
Correlation between pain and gait improvement after rehabilitation training in Parkinson's disease
  
DOI:
中文关键词: 帕金森病  康复训练  步态  疼痛
英文关键词: Parkinson's disease  rehabilitation training  gait  pain
基金项目:浙江省医药卫生一般研究计划(2016KYB293)
作者单位
吴晓强 嘉兴市第二医院神经内科浙江 嘉兴 314000 
张晓玲 嘉兴市第二医院神经内科浙江 嘉兴 314000 
官俏兵 嘉兴市第二医院神经内科浙江 嘉兴 314000 
王琰萍 嘉兴市第二医院神经内科浙江 嘉兴 314000 
徐从英 嘉兴市第二医院神经内科浙江 嘉兴 314000 
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中文摘要:
      目的:探讨在药物治疗基础上康复训练治疗步态障碍及疼痛的临床疗效以及步态与帕金森病疼痛相关性。方法:帕金森病伴疼痛患者55例随机分为训练组27例和对照组28例,2组均常规采用药物治疗,训练组加用床边康复训练及室内康复训练等方面康复训练干预综合锻炼步态及平衡功能,治疗前后采用UPDRS III评分、Berg平衡量表(BBS)、步态分析、视觉模拟评分法(VAS)等进行评定。结果:2周床边训练及4周室内步态平衡训练后,训练组患者步速、步长、髋关节屈曲最高角度、双支撑相、UPDRS III评分、BBS评分及VAS评分与治疗前比较均存在统计学差异(均P<0.05);训练组患者在步速、髋关节屈曲最大角度、双支撑相、BBS评分及VAS评分与对照组比较存在统计学意义(均P<0.05);对照组治疗前后各项指标比较差异无统计学意义。训练组患者髋关节屈曲最大角度与VAS疼痛评分、平衡能力存在相关性(r=-0.61、0.53,均P<0.01);步速与VAS疼痛评分、平衡能力存在相关性(r=-0.48、0.69,P<0.05、P<0.01);双支撑相与平衡能力存在相关性(r=-0.71,P<0.01);双支撑相与VAS疼痛评分之间相关性无统计学意义(r=0.37,P>0.05)。结论:帕金森病药物治疗基础上配合有效的康复训练,可明显改善患者姿势及步态异常,同时有利于疼痛减轻,且步态与疼痛之间存在一定的相关性。
英文摘要:
      Objective: To investigate the effects of rehabilitation training on gait disorders and pain in Parkinson's disease, as well as to explore the correlation between gait improvement and pain. Methods: Fifty-five patients with Parkinson's disease were randomly divided into experimental group (27 cases) and control group (28 cases). Both groups were treated with routine medication, and the experimental group received rehabilitation training including bedside rehabilitation training such as Bobath and indoor rehabilitation training such as gait training following audio visual stimulation. UPDRS III score, Berg balance scale (BBS), gait analysis and visual analogue scale (VAS) were assessed before and after treatment. Results: After training, the UPDRSIII score, BBS score, VAS scores and walking speed, step length, hip flexion angle were significantly improved in the experimental group (P<0.05). When compared with the control group, the experimental group performed better in the walking speed, hip flexion angle and double support phase, BBS and VAS (P<0.05). Furthermore, the maximum flexion angle of hip joint was related to VAS pain score and balance ability (r=-0.61, 0.53, P<0.01) and there was a correlation between walking pace and VAS pain score, balance ability (r=-0.48, 0.69; P<0.05, P<0.01), and a correlation between double support phase and balance ability (r=-0.71, P<0.01). However, there was no correlation between the dual support phase and the VAS pain score (r=0.37, P>0.05). Conclusion: Effective rehabilitation training can alleviate pain, and improve the postural and gait abnormalities in Parkinson's disease. At the same time, there is a certain correlation between gait improvement and pain relief.
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