运动想象联合刺激控制护理对肿瘤合并卒中患者偏瘫步态和步行能力的影响

摘要

目的 探讨运动想象联合刺激控制护理对于肿瘤合并卒中患者偏瘫步态和步行能力的影响效果.方法 选择秦皇岛市第四医院门诊输液室2014年4月至2016年4月收治的120例肿瘤合并卒中患者,根据随机数字表法分为两组,予以运动想象联合刺激控制护理干预者归为观察组,予以常规护理措施者归为对照组,每组均60例,观察干预前后两组患者的下肢运动功能、平衡能力、步行分级以及步态参数的变化.结果 干预前,两组患者的下肢运动功能、平衡能力、步行能力等级评定以及各步态参数比较差异均无统计学意义(P>0.05);干预后,与对照组的FMA-LE[(23.16±2.99)分]、BBS[(27.35±3.21)分]、5级步行能力比例(3.33％),步速[(40.11±2.23)cm/s]、步长[(39.01±2.24)cm]以及2级步行能力比例33.33％、左右步长差(6.14±0.24)cm以及步宽(11.23±1.29)cm比较,观察组的FMA-LE[(29.67±2.89)分]、BBS[(36.77±2.43)分]、5级步行能力比例(13.33％)、步速[(45.13±2.49)cm/s]、步长[(42.35±1.69)cm]均升高明显,差异具统计学意义(P<0.05),而2级步行能力比例(20.00％)、左右步长差[(4.22±0.32)cm]以及步宽[(9.62±1.72)cm]则降低明显,差异有统计学意义(P<0.05).结论 运动想象联合刺激控制护理可较好的改善肿瘤合并卒中患者的偏瘫步态,提高步行能力,具有较好的应用价值.%Objective To discuss the effect of motor imagery combined with stimulus control nursing on tumor and stroke patients'hemiplegic gait and walking ability. Methods A total of 120 cases of tumor and stroke patients, who admitted to Transfusion Room of the Fourth Hospital of Qinhuangdao from April 2014 to April 2016, were selected and divided into the control group and the observation group according to random number table, with 60 cases in each group. The observation group adopted motor imagery combined with stimulus control nursing, and the control group ad-opted normal nursing. The changes of lower limbs motor function, balanced capacity, walking classification, gait parame-ters of the two groups before and after nursing were observed. Results Before nursing intervention, there was no signif-icant difference between the two groups in the patients' lower limbs motor function, balanced capacity, walking capacity degree rating and each gait parameters (P>0.05);after the intervention, the scores of Fugl-Meyer Assessment lower ex-tremity (FMA-LE), Berg Balance Scale (BBS), 5 class walking capacity rates, walking speed, and step length in the con-trol group were respectively (23.16±2.99), (27.35±3.21), 3.33％, (40.11±2.23) cm/s, (39.01±2.24) cm, which were signifi-cantly lower than (29.67±2.89), (36.77±2.43), 13.33％, (45.13±2.49) cm/s, (42.35±1.69) cm in the observation group (P<0.05);however, 2 class walking capacity rates, left and right step difference, and stride width in the control group were respectively 33.33％, (6.14 ± 0.24) cm, (11.23 ± 1.29) cm, which were significantly higher than 20.00％, (4.22 ± 0.32) cm, (9.62±1.72) cm in the observation group (P<0.05). Conclusion Motor imagery combined with stimulus control nursing can relatively better improve tumor and stroke patients' hemiplegic gait, and increase walking ability, which has the rela-tively better application value.