文章摘要
李雪明,刘孟,吴建贤.对称负重式坐站-站坐训练对脑卒中偏瘫患者平衡功能以及ADL的影响[J].中国康复,2019,34(9):465-468
对称负重式坐站-站坐训练对脑卒中偏瘫患者平衡功能以及ADL的影响
Effect of symmetry weight-bearing sit-to-stand and stand-to-sit training on balance control and ADL in stroke patients
  
DOI:
中文关键词: 脑卒中  偏瘫  足位  坐站  站坐  下肢负重  平衡  ADL
英文关键词: stroke  hemiplegia  sit-to-stand  stand-to-sit  foot placement  balance  ADL
基金项目:
作者单位
李雪明 安徽医科大学第二附属医院康复医学科合肥 230000 
刘孟 中国科技大学第一附属医院合肥230000 
吴建贤 安徽医科大学第二附属医院康复医学科合肥 230000 
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中文摘要:
  目的:探讨对称负重式坐站-站坐训练对脑卒中偏瘫患者平衡功能以及ADL的影响。方法:48例脑卒中偏瘫患者随机分为2组各24例,生命体征平稳后均接受常规康复治疗,对照组给予常规的双足平行位进行坐站-站坐训练;观察组患者采用患足置后下坐站-站坐训练;2组患者均接受4周,每周5次,每次30min的坐站-站坐训练。训练前后分别采用Berg平衡量表(BBS)评分、改良Barthel指数评定量表 (MBI)评定平衡能力、日常生活活动能力,使用平衡评估系统测试2组患者训练前后坐位静态下压力中心点的轨迹长及轨迹面积(COP-SL、COP-SA)、训练后独立完成坐站及站坐的时间、双下肢负重对称性(WBasym)。结果:训练后,2组患者CoP-SL较训练前明显降低(P<0.01),2组患者CoP-SA、BBS及MBI较训练前明显提高(P<0.01);观察组的BBS及MBI评分更高于对照组(P<0.01),2组的坐位平衡比较差异无统计学意义。训练4周后,观察组完成坐-站转移所需的时间、健侧下肢负重、WBasym均明显低于对照组(P<0.01),患足负重明显高于对照组(P<0.01)。观察组完成站-坐转移所需的时间、健/患侧下肢负重、WBasym与对照组相比较,差异无统计学意义。结论:对称负重式坐站-站坐训练能更好地促进脑卒中偏瘫患者平衡功能以及ADL提高。
英文摘要:
  Objective: To explore the effectiveness of symmetry weight-bearing sit-to-stand (SitTS) and stand-to-sit (StandTS) training on balance function and ADL in hemiplegic stroke patients. Method: All 48 hemiplegic patients following stroke were randomly assigned to the control and experimental groups (n=24 for each group). All patients were regularly treated with physical training after their vital signs were steady. Patients in the control group were given the conventional SitTS and StandTS training, and those in the experimental group were given the modified SitTS and StandTS training in which the paretic foot was placed posteriorinferiorly. Subjects in both groups received the training 30 min every time, five times a week for four weeks. Balance control and ADL were assessed before and after the training by Berg Balance Scale (BBS) and Modified Barthel Index (MBI). A force platform for registering the centre of pressure (CoP) was used to measure CoP sway length and CoP sway areas during the static sitting. The time and weight-bearing distribution during SitTS and StandTS tasks was assessed after the training.Results: As compared with pre-training, CoP sway length and CoP sway areas in two groups significantly decreased, and BBS and MBI scores significantly increased, and more significantly in BBS and MBI scores in experimental group than in control group after four-week training. There was significant difference between two groups in time and weight-bearing distribution, and weight-bearing asymmetry (WBasym) during SitTS and StandTS tasks (P<0.05) after the treatment, however, no significant difference in CoP sway length and CoP sway areas during the static sitting between two groups (P>0.05). Conclusions: Symmetry weight-bearing SitTS and StandTS training improved the balance function and ADL in stroke patients.
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