悬吊运动疗法结合肌内效贴对脑卒中偏瘫患者平衡和步行功能的效果
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摘要
目的探讨悬吊运动疗法结合肌内效贴对脑卒中偏瘫患者平衡和步行功能的临床疗效。方法 2017年10月至2018年8月,66例脑卒中患者随机分为常规组(n=22)、悬吊组(n=22)和联合组(n=22)。三组均进行常规康复训练,悬吊组在此基础上采用悬吊运动疗法,联合组在悬吊组基础上再辅以肌内效贴。分别于治疗前和治疗4周后采用Berg平衡量表(BBS)、Fugl-Meyer评定量表下肢部分(FMA-LE)进行评定,三维运动分析系统测量步长、步频、步速和步幅。结果治疗后,三组BBS评分、FMA-LE评分和步态参数均提高(P <0.05),三组间比较,疗效由高到低依次为联合组、悬吊组和常规组(P <0.05)。结论在常规康复训练和悬吊运动疗法基础上再辅以肌内效贴干预,可以进一步提高偏瘫患者的平衡和步行功能。
Objective To investigate the effects of sling exercise therapy combined with Kinesio Taping on the balance and walking for stroke patients.Methods From October, 2017 to August, 2018, 66 patients after stroke were randomly divided into routine group(n =22), sling group(n = 22) and combined group(n = 22). All the groups accepted routine rehabilitation, while the sling group accepted sling exercise therapy based on routine group and the combined group accepted sling exercise therapy and Kinesio Taping. They were assessed with Berg Balance Scale(BBS) and Fugl-Meyer Assessment-Lower Extremities(FMA-LE), and their gait parameters were measured with Motion Analysis, before and four weeks after treatment.Results There were obvious improvements in the BBS score, FMA-LE score and gait parameters in all the groups after treatment(P < 0.05), and it was ranked from better to worse as the combined group, the sling group and the routine group(P < 0.05).Conclusion Sling exercise therapy combined with Kinesio Taping may further improve balance and walking for stroke patients.
Objective To investigate the effects of sling exercise therapy combined with Kinesio Taping on the balance and walking for stroke patients.Methods From October, 2017 to August, 2018, 66 patients after stroke were randomly divided into routine group(n =22), sling group(n = 22) and combined group(n = 22). All the groups accepted routine rehabilitation, while the sling group accepted sling exercise therapy based on routine group and the combined group accepted sling exercise therapy and Kinesio Taping. They were assessed with Berg Balance Scale(BBS) and Fugl-Meyer Assessment-Lower Extremities(FMA-LE), and their gait parameters were measured with Motion Analysis, before and four weeks after treatment.Results There were obvious improvements in the BBS score, FMA-LE score and gait parameters in all the groups after treatment(P < 0.05), and it was ranked from better to worse as the combined group, the sling group and the routine group(P < 0.05).Conclusion Sling exercise therapy combined with Kinesio Taping may further improve balance and walking for stroke patients.
引文
[1]顾昭华,龚晨,伊文超,等.多点多轴悬吊训练系统对脑卒中偏瘫患者平衡和步行能力的影响[J].中国康复医学杂志,2013,28(5):452-454.
[2]Martínez-Gramage J,Merino-Ramirez M A,Amer-Cuenca J J,et al.Effect of Kinesio Taping on gastrocnemius activity and ankle range of movement during gait in healthy adults:a randomized controlled trial[J].Phys Ther Sport,2016,18:56-61.
[3]夏道进,彭涛,魏海棠,等.下肢肌内效贴对脑卒中偏瘫患者步行功能的影响[J].中华物理医学与康复杂志,2015,37(6):427-429.
[4]何龙文,赵菁.脑卒中异常步态使用肌内效贴布的临床疗效观察[J].中国康复医学杂志,2014,29(1):74-75.
[5]Theologis T,Stebbins J.The use of gait analysis in the treatment of pediatric foot and ankle disorders[J].Foot Ankle Clin,2010,15(2):365-382.
[6]孙志成,王彤.三维运动分析系统在康复医学评估检测中的应用进展[J].中国康复医学杂志,2018,33(2):234-238.
[7]中华神经科学会,中华神经外科学会.各类脑血管病诊断要点[J].中华神经科杂志,1996,29(6):379-380.
[8]荣积峰,王卫宁,吴毅,等.悬吊核心稳定训练对脑卒中恢复期患者平衡功能和步行能力的影响[J].中国康复,2017,32(2):109-112.
[9]谭同才,叶祥明,余艳梅,等.肌内效贴布对脑卒中偏瘫患者步态的影响研究[J].中国康复医学杂志,2016,31(6):686-688.
[10]Bae Y H,Kim H G,Min K S,et al.Effects of lower-leg kinesiology taping on balance ability in stroke patients with foot drop[J].Evid Based Complementary Alternative Med,2015,2015:125629.
[11]张泓.康复评定学[M].北京:中国中医药出版社,2017:197-201.
[12]Chang W D,Huang W S,Lee C L,et al.Effects of open and closed kinetic chains of sling exercise therapy on the muscle activity of the vastus medialis oblique and vastus lateralis[J].JPhys Ther Sci,2014,26(9):1363-1366.
[13]许佳,胡世红,凌晴,等.功能性电刺激对偏瘫下肢功能及步态的影响[J].中国康复,2015,30(3):189-191.
[14]刘珏,朱玉连.躯干控制:脑卒中功能恢复的前提[J].中国康复,2013,28(3):205-209.
[15]Verheyden G,Vereeck L,Truijen S,et al.Trunk performance after stroke and the relationship with balance,gait and functional ability[J].Clin Rehabil,2006,20(5):451-458.
[16]Van Criekinge T,Saeys W,Hallemans A,et al.Trunk biomechanics during hemiplegic gait after stroke:a systematic review[J].Gait Posture,2017,54:133-143.
[17]Katsuhira J,Yamamoto S,Machida N,et al.Immediate synergistic effect of a trunk orthosis with joints providing resistive force and an ankle-foot orthosis on hemiplegic gait[J].Clin Interv Aging,2018,13(10):211-220.
[18]Cabanas-Valdés R,Bagur-Calafat C,Girabent-Farrés M,et al.The effect of additional core stability exercises on improving dynamic sitting balance and trunk control for subacute stroke patients:a randomized controlled trial[J].Clin Rehabil,2016,30(10):1024-1033.
[19]周晓辉,贾伟,邱永斌,等.早期核心肌群训练对脑卒中患者躯干控制能力的影响[J].东南国防医药,2015,17(3):269-271.
[20]Anderson K,Behm D G.Trunk muscle activity increases with unstable squat movements[J].Can J Appl Physiol,2005,30(1):33-45.
[21]张颖冬,李雪萍,林强,等.脑卒中急性期规范化康复方案对患者认知功能和运动功能的影响[J].中国康复医学杂志,2014,29(10):941-944.
[22]缪鸿石,朱镛连.脑卒中的康复评定和治疗[M].北京:华夏出版社,1996:13.
[23]陈丹,赵祥虎,徐亮,等.肌内效贴结合手指操在经桡动脉行冠状动脉介入治疗术后患者中的应用[J].护理学报,2018,25(19):62-65.
[24]孙乐影,高修明,孙楠.不同肌内效贴法在脑卒中后偏瘫患者足下垂中的临床观察[J].医学信息,2015,28(8):104-105.
[25]Shields C A,Needle A R,Rose W C,et al.Effect of elastic taping on postural control deficits in subjects with healthy ankles,copers,and individuals with functional ankle instability[J].Foot Ankle Int,2013,34(10):1427-1435.
[26]陆佳敏,高天昊,贾杰,等.肌内效贴贴扎治疗对脑卒中后下肢功能的影响[J].中国康复医学杂志,2014,29(12):1165-1167.
[27]Lee Y J,Kim J Y,Kim S Y,et al.The effects of trunk kinesio taping on balance ability and gait function in stroke patients[J].J Phys Ther Sci,2016,28(8):2385-2388.
[28]寺澤健,常冬梅,李德盛.脑卒中后遗症的步行功能康复[J].中国康复理论与实践,2011,17(9):813-817.
[29]Yazici G,Guclu-Gunduz A,Bayraktar D,et al.Does correcting position and increasing sensorial input of the foot and ankle with Kinesio Taping improve balance in stroke patients?[J].NeuroRehabilitation,2015,36(3):345-353.
[30]陈文华,余波,陈佩杰.软组织贴扎技术临床应用精要[M].上海:浦江教育出版社,2012:80-81.
[31]Briem K,Eyth?rsd?ttir H,Magnúsdóttir R G,et al.Effects of kinesio tape compared with nonelastic sports tape and the untaped ankle during a sudden inversion perturbation in male athletes[J].J Orthop Sports Phys Ther,2011,41(5):328-335.
[32]卢战,唐艳,胡凤丹.触发式功能性电刺激训练结合肌内效贴对脑卒中偏瘫足下垂患者步行能力的影响[J].中国康复医学杂志,2018,33(9):1102-1104.
[2]Martínez-Gramage J,Merino-Ramirez M A,Amer-Cuenca J J,et al.Effect of Kinesio Taping on gastrocnemius activity and ankle range of movement during gait in healthy adults:a randomized controlled trial[J].Phys Ther Sport,2016,18:56-61.
[3]夏道进,彭涛,魏海棠,等.下肢肌内效贴对脑卒中偏瘫患者步行功能的影响[J].中华物理医学与康复杂志,2015,37(6):427-429.
[4]何龙文,赵菁.脑卒中异常步态使用肌内效贴布的临床疗效观察[J].中国康复医学杂志,2014,29(1):74-75.
[5]Theologis T,Stebbins J.The use of gait analysis in the treatment of pediatric foot and ankle disorders[J].Foot Ankle Clin,2010,15(2):365-382.
[6]孙志成,王彤.三维运动分析系统在康复医学评估检测中的应用进展[J].中国康复医学杂志,2018,33(2):234-238.
[7]中华神经科学会,中华神经外科学会.各类脑血管病诊断要点[J].中华神经科杂志,1996,29(6):379-380.
[8]荣积峰,王卫宁,吴毅,等.悬吊核心稳定训练对脑卒中恢复期患者平衡功能和步行能力的影响[J].中国康复,2017,32(2):109-112.
[9]谭同才,叶祥明,余艳梅,等.肌内效贴布对脑卒中偏瘫患者步态的影响研究[J].中国康复医学杂志,2016,31(6):686-688.
[10]Bae Y H,Kim H G,Min K S,et al.Effects of lower-leg kinesiology taping on balance ability in stroke patients with foot drop[J].Evid Based Complementary Alternative Med,2015,2015:125629.
[11]张泓.康复评定学[M].北京:中国中医药出版社,2017:197-201.
[12]Chang W D,Huang W S,Lee C L,et al.Effects of open and closed kinetic chains of sling exercise therapy on the muscle activity of the vastus medialis oblique and vastus lateralis[J].JPhys Ther Sci,2014,26(9):1363-1366.
[13]许佳,胡世红,凌晴,等.功能性电刺激对偏瘫下肢功能及步态的影响[J].中国康复,2015,30(3):189-191.
[14]刘珏,朱玉连.躯干控制:脑卒中功能恢复的前提[J].中国康复,2013,28(3):205-209.
[15]Verheyden G,Vereeck L,Truijen S,et al.Trunk performance after stroke and the relationship with balance,gait and functional ability[J].Clin Rehabil,2006,20(5):451-458.
[16]Van Criekinge T,Saeys W,Hallemans A,et al.Trunk biomechanics during hemiplegic gait after stroke:a systematic review[J].Gait Posture,2017,54:133-143.
[17]Katsuhira J,Yamamoto S,Machida N,et al.Immediate synergistic effect of a trunk orthosis with joints providing resistive force and an ankle-foot orthosis on hemiplegic gait[J].Clin Interv Aging,2018,13(10):211-220.
[18]Cabanas-Valdés R,Bagur-Calafat C,Girabent-Farrés M,et al.The effect of additional core stability exercises on improving dynamic sitting balance and trunk control for subacute stroke patients:a randomized controlled trial[J].Clin Rehabil,2016,30(10):1024-1033.
[19]周晓辉,贾伟,邱永斌,等.早期核心肌群训练对脑卒中患者躯干控制能力的影响[J].东南国防医药,2015,17(3):269-271.
[20]Anderson K,Behm D G.Trunk muscle activity increases with unstable squat movements[J].Can J Appl Physiol,2005,30(1):33-45.
[21]张颖冬,李雪萍,林强,等.脑卒中急性期规范化康复方案对患者认知功能和运动功能的影响[J].中国康复医学杂志,2014,29(10):941-944.
[22]缪鸿石,朱镛连.脑卒中的康复评定和治疗[M].北京:华夏出版社,1996:13.
[23]陈丹,赵祥虎,徐亮,等.肌内效贴结合手指操在经桡动脉行冠状动脉介入治疗术后患者中的应用[J].护理学报,2018,25(19):62-65.
[24]孙乐影,高修明,孙楠.不同肌内效贴法在脑卒中后偏瘫患者足下垂中的临床观察[J].医学信息,2015,28(8):104-105.
[25]Shields C A,Needle A R,Rose W C,et al.Effect of elastic taping on postural control deficits in subjects with healthy ankles,copers,and individuals with functional ankle instability[J].Foot Ankle Int,2013,34(10):1427-1435.
[26]陆佳敏,高天昊,贾杰,等.肌内效贴贴扎治疗对脑卒中后下肢功能的影响[J].中国康复医学杂志,2014,29(12):1165-1167.
[27]Lee Y J,Kim J Y,Kim S Y,et al.The effects of trunk kinesio taping on balance ability and gait function in stroke patients[J].J Phys Ther Sci,2016,28(8):2385-2388.
[28]寺澤健,常冬梅,李德盛.脑卒中后遗症的步行功能康复[J].中国康复理论与实践,2011,17(9):813-817.
[29]Yazici G,Guclu-Gunduz A,Bayraktar D,et al.Does correcting position and increasing sensorial input of the foot and ankle with Kinesio Taping improve balance in stroke patients?[J].NeuroRehabilitation,2015,36(3):345-353.
[30]陈文华,余波,陈佩杰.软组织贴扎技术临床应用精要[M].上海:浦江教育出版社,2012:80-81.
[31]Briem K,Eyth?rsd?ttir H,Magnúsdóttir R G,et al.Effects of kinesio tape compared with nonelastic sports tape and the untaped ankle during a sudden inversion perturbation in male athletes[J].J Orthop Sports Phys Ther,2011,41(5):328-335.
[32]卢战,唐艳,胡凤丹.触发式功能性电刺激训练结合肌内效贴对脑卒中偏瘫足下垂患者步行能力的影响[J].中国康复医学杂志,2018,33(9):1102-1104.