核心稳定性训练结合运动再学习疗法对脑卒中后下肢运动功能障碍的疗效

摘要

目的:探讨核心稳定性训练(CST)结合运动再学习疗法(MRP)对脑卒中后下肢运动功能障碍的疗效.方法:脑卒中患者80例随机分为对照组和观察组各40例,2组均行常规神经内科药物治疗和MRP,观察组在训练前进行CST训练.治疗前后采用简式Fugl-Meyer运动功能量表(FMA)评价患者下肢运动功能,躯干控制测试(TCT)进行躯干控制能力评定,改良Barthel指数法(MBI)进行日常生活活动能力评定.治疗后行步行能力评定.结果:治疗6周后,2组患者下肢FMA、MBI及TCT评分均较治疗前明显提高(P＜0.01),且观察组更高于对照组(P＜0.01).治疗后,2组步行相关参数比较,观察组最大步行速度、步长及步宽均明显高于对照组(P＜0.01).多因素相关性分析发现患者躯干控制能力分别与下肢运动功能、日常生活活动能力、步长和步行速度具有正相关性(P＜0.01).结论:CST结合MRP可显著提高脑卒中患者下肢运动功能.%Objective: To investigate the effect of core stability training (CST) combined with motor relearning pro-gramne (MRP) in the treatment of limb dysfunction after stroke. Methods:Eighty stroke patients were randomly divided into the control group (n = 40) and the observation group (n = 40), receiving routine neurological treatments including drug and MRP,and CST before MRP, respectively, twice every day and 40 min every time for 6 weeks. Simple Fugl-Meyer motor function scale (Fugl-Meyer assessment,FMA) was used to evaluate hindlimb motor function (total score: 34 points), body control test (TCT) to assess trunk control ability, and modified Barthel index (MBI) to assess activities of daily living (ADD. The patients were assessed before and after treatment including hindlimb motor function and ADL. Walking ability was evaluated after six weeks. Results: After treatment for 6 weeks,FMA,MBI and TCT scores of the lower limbs were significantly increased as compared with those before treatment it test,P<0. 01) ,more significantly in the observation group than in the control group (P<0. 01); Walking ability in the observation group was significantly improved as compared with the control group (P<0. 01). Multi-factor analysis revealed that body control ability was positively correlated with hindlimb motor function, MBI ability,and step and walking speed (P<0. 01). Conclusion:CST in combination with MRP can significantly improve hindlimb motor function in patients with stroke.