简易膝关节训练器对脑卒中偏瘫患者膝关节屈曲主动运动的疗效

doi:10.3969/j.issn.1006-9771.2022.03.013

摘要/Abstract

摘要： 目的观察简易膝关节训练器改善脑卒中偏瘫患者膝关节屈曲主动运动的临床疗效。方法 2020年3月至2021年5月,选择本院46例脑卒中后偏瘫患者,随机分为对照组和试验组各23例。两组均接受常规康复训练,试验组增加用简易膝关节训练器坐位下行膝关节屈曲主动运动训练,共8周。训练前、后测量坐位膝关节主动屈曲角度和Holden步行功能分级,采用步态分析系统测量摆动时膝关节屈曲最大角度。结果训练后,两组膝关节主动活动度及步行中摆动期膝关节最大屈曲角度均显著提高(|t| > 6.991, P < 0.001),且试验组提高更多(t > 2.185, P < 0.05);两组Holden步行功能分级均明显提高(|Z| > 2.828, P < 0.01),两组间无显著性差异(Z = -0.821, P = 0.412)。结论应用简易膝关节训练器训练能有效改善膝关节主动屈曲活动度,可在临床和社区康复中应用。

关键词: 脑卒中, 偏瘫, 简易膝关节训练器, 膝, 屈曲, 主动运动, 步行

Abstract: Objective To observe the clinical efficacy of simple knee trainer on active knee flexion in patients with hemiplegia after stroke.Methods From March, 2020 to May, 2021, 46 hemiplegics after stroke in Beijing Bo'ai Hospital were randomly divided into control group (n = 23) and experimental group (n = 23). Both groups accepted routine rehabilitation training, and the experimental group accepted knee flexion exercise training in sitting position through the simple knee trainer, for eight weeks. They were measured active knee flexion angle in sitting position and maximum flexion angle in walking before and after training, as well as Holden Functional Ambulation Category (FAC).Results Both active knee flexion angle in sitting position and maximum flexion angle in walking significantly increased in both groups after training (|t| > 6.991, P < 0.001), and increased more in the experimental group than in the control group (t > 2.185, P < 0.05). The grade of FAC also improved in both groups (|Z| > 2.828, P < 0.01), and no significant difference was found between groups (Z = -0.821, P = 0.412).Conclusion The application of simple knee trainer can effectively improve the active range of motion of knee, which may be used in clinic- and community-based rehabilitation.

Key words: stroke, hemiplegia, simple knee trainer, knee, flexion, active movement, walking

朱琳,常冬梅,王亚囡,刘元旻,刘惠林. 简易膝关节训练器对脑卒中偏瘫患者膝关节屈曲主动运动的疗效[J]. 《中国康复理论与实践》, 2022, 28(3): 356-360.

ZHU Lin,CHANG Dongmei,WANG Ya'nan,LIU Yuanmin,LIU Huilin. Effect of simple knee trainer on knee active flexion for hemiplegics after stroke[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2022, 28(3): 356-360.

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项目	对照组 (n = 23)	试验组 (n = 23)	χ²/t/Z值	P值
性别(男/女)/n	19/4	16/7	1.075	0.300
年龄/岁	49.17±10.90	47.52±14.19	-0.443	0.660
体质量/kg	67.46±8.62	65.04±8.28	-0.969	0.338
身高/cm	1.71±0.06	1.69±0.07	-0.849	0.401
BMI/kg·m^-2	23.12±2.18	22.70±1.74	-0.724	0.473
性质(出血/梗死)/n	12/11	12/11	0.000	1.000
偏瘫侧(右/左)/n	9/14	11/12	0.354	0.552
病程/月	5.26±3.22	4.83±2.72	-0.494	0.624
Brunnstrom分期	3(1)^a	3(1)^a	-1.386	0.166

组别	n	试验前	试验后	t值	P值
对照组	23	93.65±7.54	97.20±7.91	-7.176	< 0.001
试验组	23	91.66±3.80	103.91±8.17	-8.655	< 0.001
t值		-1.126	2.833
P值		0.266	0.007

组别	n	试验前	试验后	t值	P值
对照组	23	24.74±11.78	26.37±11.76	-6.991	< 0.001
试验组	23	20.52±9.51	33.12±8.90	-25.590	< 0.001
t值		-1.337	2.185
P值		0.188	0.034

组别	n	试验前	试验后	Z值	P值
对照组	23	2.96±0.147	3.30±0.183	-2.828	0.005
试验组	23	2.70±0.132	3.57±0.164	-4.264	< 0.001
Z值		-1.274	-0.821
P值		0.208	0.412