减重平板训练对胸腰段骨折伴脊髓损伤患者步行功能的影响

摘要

目的：研究减重平板步行训练对脊柱胸腰段骨折伴脊髓不完全损伤患者功能疗效的影响。方法：将胸腰段骨折伴脊髓不完全损伤患者36例随机分为减重运动平板训练组（BWSTT，n=18）和常规物理治疗组（PT，n=18），PT组采用常规及传统物理治疗，BWSTT组采用常规及传统物理治疗与减重平板步行训练。两组患者均于治疗前、后（12周）进行10米步行测试（10—Meter Walj Test，10MWT）、脊髓独立性评定量表III（SCIMⅢ，Spinal Cord Independence Measure III）、下肢周径及骨密度检测。结果：PT组SCIII 评分及10MWT较训练前分别增加21.6%（P<0.05）和24.0%（P<0.05），BWSTT 组患者较训练前分别增加39.88%（P<0.05）、96.6%（P<0.05）。经减重运动平板训练后，BWSTT组患者的SCIM III 评分、步行速度较PT组患者分别增加44.78%（P<0.05）及46.88%（P<0.05）。BWSTT组骨密度及骨骼肌周径较训练前分别增加31.15%（P<0.05）、69.76%（P<0.05），而PT组较训练前分别增加11.36%（ P>0.05）、28%（ P>0.05），BWSTT组的骨密度及骨骼肌周径较 PT组分别增加23.18%（ P<0.05）、10.91%（ P>0.05）。结论：减重平板步行训练可提高胸腰段骨折伴脊髓不完全损伤患者胸腰段骨密度，增强下肢步行能力，有效改善患者日常生活能力。%Objective To observe the effect of body—weight supported treadmill training on the treatment of incomplete spinal cord injury after the thoracolumbar fracture. Method 36 patients after thoracolumbar fractures were randomly divided into two groups. The patients in the one group were treated with body—weight supported treadmill training( BWSTT),while the others were treated mainly with regular physical treatment(PT). Patients were scored with the 10MWT,SCIMⅢ,diameters of lower limb and BMD initially and after 12 weejs. Results The 10MWT and SCIMⅢscores of all patients in PT groups were significantly increased by 21. 6% and 24. 0% after 12 weejs than before. Those in the BWSTT group were significantly improved by 39. 88% and 96. 6% than before as well( P<0. 05). However,both of them were signifi-cantly increased by 44. 78%(P<0. 05)and 46. 88%(P<0. 05)in BWSTT compared to the PT. The BWSTT group diameters of lower limb and BMD were increased by 31. 15%(P<0. 05),69. 76%(P<0. 05). They were also increased by 11. 36%(P>0. 05)and 28%(P>0. 05)in PT group than before. However,they both increased by 23. 18%( P < 0. 05 ) and 10. 91%( P > 0. 05 ) in BWSTT than PT. Conclusion Body—weight supported treadmill training can effectively improve ability in the activities of daily living and locomotor abili-ties after thoracolumbar fracture.