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范子言, 李宝金, 廖伶艺, 等. 躯干控制训练对急性期脑卒中偏瘫患者动态坐位平衡和躯干功能影响的随机对照试验[J]. 四川大学学报(医学版), 2020, 51(6): 847-852. DOI: 10.12182/20201160201
引用本文: 范子言, 李宝金, 廖伶艺, 等. 躯干控制训练对急性期脑卒中偏瘫患者动态坐位平衡和躯干功能影响的随机对照试验[J]. 四川大学学报(医学版), 2020, 51(6): 847-852. DOI: 10.12182/20201160201
FAN Zi-yan, LI Bao-jin, LIAO Ling-yi, et al. Effects of Trunk Control Training on Dynamic Sitting Balance and Trunk Function in Hemiplegia Patients after Acute Stroke[J]. Journal of Sichuan University (Medical Sciences), 2020, 51(6): 847-852. DOI: 10.12182/20201160201
Citation: FAN Zi-yan, LI Bao-jin, LIAO Ling-yi, et al. Effects of Trunk Control Training on Dynamic Sitting Balance and Trunk Function in Hemiplegia Patients after Acute Stroke[J]. Journal of Sichuan University (Medical Sciences), 2020, 51(6): 847-852. DOI: 10.12182/20201160201

躯干控制训练对急性期脑卒中偏瘫患者动态坐位平衡和躯干功能影响的随机对照试验

Effects of Trunk Control Training on Dynamic Sitting Balance and Trunk Function in Hemiplegia Patients after Acute Stroke

  • 摘要:
      目的  探讨躯干控制训练对急性期脑卒中偏瘫患者的躯干功能、平衡、移动能力和功能独立性的影响,并与常规脑卒中康复治疗进行疗效对比。
      方法  本研究采用随机对照试验设计,受试者和评估者盲,治疗师非盲。通过计算机生成的随机数字表将受试者随机分配到试验组或对照组。试验组(n=15)每次接受30 min高强度躯干控制训练加15 min低强度常规脑卒中康复治疗(共45 min,每天1次,5 d);对照组(n=15)每次只接受45 min低强度常规脑卒中康复治疗,每天1次,5 d。躯干功能是主要结局指标,采用躯干损伤量表(trunk impairment scale,TIS)评估,次要结局指标包括平衡、移动能力和功能独立性,采用Brunel平衡量表(brunel balance assessment,BBA)、改良的Rivermead移动指数(modified rivermead mobility index,MRMI)和改良的Barthel指数(modified barthel index,MBI)评估。在干预前、后对受试者进行评估。
      结果  共纳入30例脑梗死患者,平均年龄(62.93±13.51)岁,男性21例,女性9例。治疗前两组基线可比。最终27例完成规定的康复训练,试验组有2例中途退出,对照组有1例中途退出,评估者在这3例受试者接受第4次治疗后对其进行了结局指标的评估,结果纳入结果分析。两种干预方法都没有发生不良事件。两组患者治疗前,干预前各项观察指标差异无统计学意义。两组患者治疗5 d后,TIS总表、TIS静态坐位平衡亚表、TIS协调亚表、BBA、MRMI和MBI得分均较治疗前增加,但治疗后两组间比较差异无统计学意义(P均>0.05)。与对照组比较,躯干控制训练组治疗后对动态坐位平衡的改善更显著,TIS动态坐位平衡亚表分数的增加更多,差异有统计学意义(P<0.05)。
      结论  躯干控制训练对急性期脑卒中偏瘫患者的躯干功能、平衡、移动能力和日常生活活动能力有改善,且躯干控制训练比常规脑卒中康复治疗更能改善动态坐位平衡。

     

    Abstract:
      Objective  To investigate the effect of trunk control training on trunk function, balance, mobility and functional independence in hemiplegia patients after acute stroke, and to compare the therapeutic effects with conventional stroke rehabilitation.
      Methods  The study was designed as a randomized controlled trial. The subjects and evaluators were blinded and the therapist was unblinded. Subjects were randomly assigned to either the experimental group or the control group using a computer-generated random number table, the experimental group (n=15) received30 min of high-intensity trunk control training plus 15 min of low-intensity conventional stroke rehabilitation (45 min, once1 d for 5 d). The control group (n=15) received only 45 min low-intensity conventional stroke rehabilitation, once 1 d for 5 d. Trunk function was the primary outcome, which was evaluated by the Trunk Impairment Scale (TIS). The secondary outcome included balance, mobility and functional independence, which were assessed by the Brunel Balance Assessment (BBA), the Modified Rivermead Mobility Index (MRMI) and the modified Barthel Index (MBI). Subjects were assessed before and after the intervention.
      Results  After 5 d of treatment, the scores of TIS general table, TIS static sitting balance sub table, TIS coordination sub table, BBA, MRMI and MBI were increased, but there was no statistically significant difference between the two groups (all P>0.05). The trunk control training group improved dynamic sitting balance more significantly, the score of TIS dynamic sitting balance sub table increased more than that in the control group, with a statistically significant difference (P<0.05).
      Conclusion  The results of this study indicate that trunk control training has improved trunk function, balance, mobility, and activities of daily living in hemiplegia patients after acute stroke, and trunk control training improves dynamic sitting balance more effectively than conventional stroke rehabilitation.

     

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