Effects of active and passive training apparatus combined with rehabilitation training on lower limb function of stroke patients during recovery period

摘要

BACKGROUND: Stroke patients always spontaneously do some learning and training of motor functions;however, learning and training are not prompt and right, while patients do not have enough activity amounts.Active and passive motor training apparatus is aimed directly at lower limb training so as to stimulate nerve function through stimulating muscular movement. Based on motor mileage, motor time, various power supplies and velocity of active and passive training apparatus, we can understand the training condition and adjust training program.OBJECTIVE: To observe the effects of grade-III rehabilitation training combining with active and passive training apparatus on lower limb function, muscle strength and activity of daily living (ADL) in stroke patients during recovery period.DESIGN: Contrast observation.SETTING: Department of Rehabilitation, Jilin Academic Institute of Traditional Chinese Medicine.PARTICIPANTS: A total of 80 patients with stroke-induced hemiplegia after stabilizing vital signs for 2 weeks were selected from Department of Rehabilitation, Jilin Academic Institute of Traditional Chinese Medicine from January to June 2007. There were 47 males and 33 females, and their ages ranged from 41 to 75 years. All patients met the diagnostic criteria of the Fourth National Cerebrovascular Disease Academic Meeting in 1995 and were diagnosed as cerebral hemorrhage or cerebral infarction through CT or MRI examinations in clinic. Patients and their parents provided the confirmed consent. Based on therapeutic orders of hospitalization, patients were randomly divided into treatment group and control group with 40 patients in each group.METHODS: Patients in the control group received physical therapy and occupational therapy combining with rehabilitative treatment based on grade-Ⅲ rehabilitative treatment program, which was set by the National Cerebrovascular Disease Topic Group. In addition, patients in the treatment group were trained with active and passive motor training apparatus based on therapeutic procedures in the control group. The active and passive motor training apparatus was designed as the therapeutic style of nervous system; otherwise, the treatment was performed once a day, 30 minutes once and 6 times per week. Four weeks were regarded as a course.MAIN OUTCOME MEASURES: Before treatment, at 2 weeks after treatment and after the first course,bare-handed muscle strength examination was used to check muscle strength and muscular tension; in addition, simple Fugl-Meyer assessment (FMA) and diagnostic criteria which were set by the Fourth National Cerebrovascular Disease Academic Meeting were used to evaluate motor function of limbs and total ADL.RESULTS: All 80 stroke patients were involved in the final analysis. ① Muscle strength of lower limbs was improved in both treatment group and control group. After the first course, muscle strength in the treatment group was obviously superior to that in the control group ( χ2=6.64, P ＜ 0.05). ② After the first course, Fugl-Meyer scores in the treatment group were higher than those in the control group, and there was significant difference (t =2.82, P ＜ 0.05). ③ Muscular tension of lower limbs was not changed in both treatment group and control group after treatment (P ＞ 0.05). ④ After the first course, ADL in the treatment group was superior to that in the control group (P ＜ 0.05). Among patients in the treatment group, 24 cases (60%) had obvious progress, 16 (40%) had progress, and 0 (0%) did not have any changes. On the other hand,among patients in the control group, 13 cases (32.5%) had obvious progress, 26 (65%) had progress, and 1 (2.5%) did not have any changes.CONCLUSION: Rehabilitation training combining with active and passive motor training apparatus can promote the recovery of lower limb disorder, increase muscle strength, control spasm, improve ADL and cause satisfactorily clinical effects in stroke patients during recovery period.