文章摘要
杜雪晶,王亚囡,金龙,刘建华.水中平板运动对脑卒中后偏瘫患者平衡功能的影响和机制研究[J].中国康复,2022,37(8):468-472
水中平板运动对脑卒中后偏瘫患者平衡功能的影响和机制研究
Effect of Underwater Treadmill Training on Balance Function in Hemiplegia Patients After Stroke and Underlying Mechanism
  
DOI:
中文关键词: 水中平板运动,平衡功能,腹横肌厚度,偏瘫
英文关键词: underwater treadmill exercise  balance function  transversus abdominis muscle thickness  hemiplegia
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作者单位
杜雪晶 1.中国康复研究中心北京博爱医院神经系统理学疗法科北京 1000682.首都医科大学康复医学院北京 100068 
王亚囡 1.中国康复研究中心北京博爱医院神经系统理学疗法科北京 1000682.首都医科大学康复医学院北京 100068 
金龙 1.中国康复研究中心北京博爱医院a.神经系统理学疗法科b.理疗科北京 100068 
刘建华 1.中国康复研究中心北京博爱医院神经系统理学疗法科北京 1000682.首都医科大学康复医学院北京 100068 
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中文摘要:
  目的:研究水中平板运动对亚急性期偏瘫患者平衡功能的影响及其机制。方法:选取首次发病的偏瘫患者34例,分为观察组17例接受水中平板运动及陆上运动训练,对照组17例接受陆上运动训练;选取13例健康青年男性作为健康参照组。研究开始前、4周后,测量2组患者的Berg平衡量表(BBS)评分,两侧腹横肌厚度,患侧下肢股直肌、胫前肌和腓肠肌厚度,计算两侧腹横肌厚度比及患侧下肢主要抗重力肌群增厚比。腹横肌厚度、BBS评分等计量资料进行参数检验,腹横肌厚度比、下肢主要抗重力肌群增厚比等比值资料进行非参数检验,BBS评分与下肢抗重力肌群增厚比进行非参数相关性分析。结果:治疗4周后,2组两侧腹横肌厚度及BBS评分均较治疗前显著提高(均P<0.01);观察组患侧腹横肌厚度较对照组显著提高(P<0.05)。治疗前,2组患者腹横肌厚度比均低于健康组(均P<0.05) 。治疗后,2组患者及健康组3组间均差异无统计学意义,观察组患者患侧下肢主要肌群增厚比较对照组有显著提高(均P<0.05),观察组下肢股直肌增厚比与胫前肌、外侧腓肠肌增厚比呈负相关(P<0.05) ,胫前肌与外侧腓肠肌增厚比呈正相关(P<0.05),2组患者BBS评分与各下肢肌群增厚比无显著相关性。结论:水中平板运动和陆上运动训练均可以提高偏瘫患者的平衡功能,水中平板运动可以有效提高患侧腹横肌厚度,改善异常的腹横肌形态,增强下肢主要抗重力肌群力量,改善步态。
英文摘要:
  Objective: To explore the effect of underwater treadmill exercise on the balance function of patients in the subacute stage and its possible mechanism. Methods: From July 2021 to January 2022, 34 patients with hemiplegia who had the first onset at the China Rehabilitation Research Center were randomly selected. Among them, 17 patients in the experimental group received underwater treadmill exercise and land exercise training, and 17 patients in the control group received land exercise training. A total of 13 healthy young men were randomly selected as the control group. Before and 4 weeks after the treatment, the Berg balance scale scores, the thickness of the transverse abdominis muscle on both sides, the thickness of the rectus femoris muscle of the affected lower limb, the thickness of the tibialis anterior muscle, and the thickness of the gastrocnemius muscle were measured, and the thickness ratio of the transverse abdominis muscle, rectus femoris muscle, tibialis anterior muscle, gastrocnemius muscle were calculated. The thickness ratio of the main anti-gravity muscles of the lower extremity on the affected side was compared.The parametric data of abdominal transverse muscle thickness and BBS score were analyzed by parametric test; thickness ratio of abdominal transverse muscle and that of main anti-gravity muscle group of lower limbs by non-parametric test, and post-test score of BBS and thickness ratio of lower limb anti-gravity muscle group by bivariate non-parametric correlation analysis. Results: After 4 weeks of treatment, the thickness of transverse abdominis and BBS scores were significantly higher than before (allP<0.01); the transverse abdominal muscle thickness of affected side in experimental group was significantly higher than the control group (P<0.05). Before treatment, the thickness ratio of transverse abdominis in 2 groups of patients were lower than those in the healthy group (all P<0.05). After treatment, there was no significant difference in thickness ratio of transverse abdominis ammg 3 groups Com-. pared with the control group, the thickening ration of the major muscles of affected lower limbs in the experimental group was significantly increased (all P<0.05), the thickening ratio of rectus femoris was negatively correlated with the thickening ratio of tibialis anterior and lateral gastrocnemius in experimental group(P<0.05),the thickening ratio of tibialis anterior muscle and lateral gastrocnemius muscle was positively correlated (P<0.05), and there was no significant correlation between BBS score and the thickening ratio of lower extremity muscles in the two groups .Conclusion: Underwater treadmill exercise can improve the balance function of patients with hemiplegia, increase the thickness of the transverse abdominis muscle on the affected sides, improve the shape of transverse abdominis muscle, enhance the strength of the main anti-gravity muscles of the lower limbs, and ameliorate the gait.
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