| 杨雪梅,张孝林,陈瑶,等.序贯性轮椅使用结合康复训练对老年脑卒中偏瘫患者下肢功能和平衡能力的影响[J].中国临床保健杂志,2023,26(2):215-220. |
| 序贯性轮椅使用结合康复训练对老年脑卒中偏瘫患者下肢功能和平衡能力的影响 |
| Effects of sequential wheelchair use combined with rehabilitation training on lower limb function and balance ability in elderly patients with stroke hemiplegia |
| 投稿时间：2023-01-06 |
| DOI：10.3969/J.issn.1672-6790.2023.02.017 |
| 中文关键词: 卒中 偏瘫 康复 运动疗法 轮椅 |
| 英文关键词: Stroke Hemiplegia Rehabilitation Exercise therapy Wheelchairs 〖FL |
| 基金项目:上海市静安区卫生科研项目(2019HL03,2020MS17)；上海市静安区卫生系统重点学科建设资助项目(2021PY04)；上海市卫生健康委员会科研项目(202040034)；上海市静安区卫生科研课题(2020MS17) |
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| 中文摘要: |
| 目的 探讨序贯性轮椅使用结合康复训练对老年脑卒中偏瘫患者下肢功能和平衡能力的影响。方法 选取2020年6月1日至2022年6月30日上海市第三康复医院122例脑卒中偏瘫患者,按随机数字表法分为观察组与对照组,各61例。2组在接受常规综合康复治疗的基础上,对照组常规自选轮椅使用,观察组给予序贯性轮椅使用,持续干预8周,比较2组干预后下肢痉挛状态[改良Ashworth痉挛量表(MAS)]、下肢运动功能[简式Fugl-Meyer 运动功能评测表(FMA)]、平衡功能[脑卒中姿势评定量表(PASS)、Berg平衡量表(BBS)评分]、日常生活能力[改良Barthel 指数(MBI)评分]、表面肌电图[患侧股四头肌、胫骨前肌表面肌电积分值(iEMG)、表面肌电均方根(RMS)值]差异。结果 观察组干预后4周、8周时,下肢痉挛MAS分级改善优于对照组(P＜0.05),下肢肢体运动功能FMA评分高于对照组(P＜0.05),平衡功能PASS评分及BBS评分均高于对照组(P＜0.05),日常生活能力MBI评分高于对照组(P＜0.05),胫骨前肌及股四头肌iEMG水平均高于对照组,RMS水平低于对照组(P＜0.05)。结论 序贯性轮椅使用结合康复训练有利于减轻老年脑卒中偏瘫患者下肢痉挛状态,增强患者肢体运动和平衡功能,提高其日常生活能力,促进股四头肌、胫骨前肌功能恢复。 |
| 英文摘要: |
| Objective To explore the effects of sequential wheelchair use combined with rehabilitation training on lower limb function and balance ability in elderly patients with stroke hemiplegia.Methods A total of 122 patients with stroke hemiplegia in the hospital were enrolled and randomly divided into observation group and control group between June 1,2020 and June 30,2022,61 cases in each group.After routine comprehensive rehabilitation therapy in both groups,control group was given routine self-selected wheelchair use,while observation group was given sequential wheelchair use for 8 weeks.The differences in lower limb spasticity[modified Ashworth Scale (MAS)],lower limb motor function[Fugl-Meyer motor function assessment (FMA)],balance function[Postural Assessment Scale for Stroke Patients (PASS),Berg Balance Scale (BBS)],activities of daily living[Modular Building Institute (MBI)]and surface eletromyography[integrated eletromyography (iEMG) of quadriceps femoris and tibialis anterior muscles on affected side),root mean square (RMS) of surface EMG]in the two groups were compared after intervention.Results At the 4th and 8th weeks after intervention,improvement of MAS grading was better in observation group than control group (P<0.05),FMA score was higher in observation group (P<0.05),scores of PASS and BBS were higher in observation group (P<0.05),and MBI score was higher in observation group (P<0.05).At the 4th and 8th weeks after intervention,iEMG values of tibialis anterior muscle and quadriceps femoris were greater in observation group than control group,and RMS level was lower in observation group (P<0.05).Conclusions Sequential wheelchair use combined with rehabilitation training is beneficial to relieve lower limb spasticity,enhance limb motor and balance function,improve activities of daily living and promote function recovery of quadriceps femoris and tibialis anterior muscles in elderly patients with stroke hemiplegia. |
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