可被动活动下肢的电动起立床对颈髓损伤患者站立训练的影响

摘要

Objective: To observe the effects of electrically operated and integrated with passive leg movements tilt table on the adverse reaction rate in standing training, the time of standing training, mobility function, sensory function and activities of daily living function of cervical spinal cord injured patients.Method: Twenty-three cervical spinal cord injured patients were randomized into the standing training on electrically operated and integrated with passive leg movements tilt table group (treatment group, n=10) and the standing training on traditional electrically operated tilt table group (control group, n=13). The adverse reaction rate, the time for patients being able to stand at 90° for at least lOmin, the motor scores, the sensory index scores and Barthel index scores before treatment and after 4 weeks treatment were compared between the two groups Result: After treatment the adverse reaction rate showed a reducing trend along with the increasing of standing times, and the was lower in treatment group than that in control group(P<0.05). The treatment group needed 9.8 ± 4.16d to stand at 90° for at least lOmin, while the control group needed 16.46 ± 5.42d(P<0.05). After 4 weeks treatment, the motor scores and Barthel index scores were significant higher than those before treatment (P<0.05),but no significant difference was found between treatment group and control group (P>0.05); compared with before treatment the sensory index scores showed no significant difference (P>0.05).Conclusion: Compared to the traditional electrically operated lilt table standing training, standing training on elei- trically operated combining with passive leg movements tilt table can reduce the adverse reaction rate in standing training, and decrease the training days for patients being able to stand up, so it is beneficial for the rehabilitation of cervical spinal cord injured patients.u0000inin%目的:观察可被动活动下肢的电动起立床对颈髓损伤患者在站立训练中不良反应的发生,以及站立训练时间、运动功能、感觉功能、日常生活活动能力的影响.方法:将23例确诊为颈髓损伤,损伤平面位于C4-C8,ASIA分级为A-B级,病程在3个月内以卧床为主的患者,随机分为实验组(n=10)和对照组(n=13),分别进行下肢活动式电动起立床训练和普通电动起立床训练,观察两组不良反应发生率、完成训练所需时间、运动评分、感觉指数评分、Barthel指数评分.结果:随站立次数增加,两组患者的不良反应发生率均呈下降趋势,在各时期实验组患者不良反应发生率均低于对照组(p＜0.05),实验组患者完成站立训练所需时间更短(实验组9.8±4.16d,对照组16.46±5.42d,P＜0.05),在治疗4周后,实验组和对照组患者的运动评分和Barthel指数得分均得到了提高,但两组间无显著差异,两组患者的感觉指数评分与治疗前的差异无显著性意义.结论:带有下肢被动活动功能的电动起立床可减少站立训练中不良反应的发生,完成站立训练所需时间更短,效果显著优于普通电动起立床,更有利于加快颈髓损伤患者康复进程,适于临床推广应用.