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邓思宇,胡 楠,卢 茜,郄淑燕,刘 畅,毕 胜.牵伸训练改善脑卒中踝关节痉挛的随机对照研究[J].中国康复医学杂志,2015,(12):1228~1233
牵伸训练改善脑卒中踝关节痉挛的随机对照研究    点此下载全文
邓思宇  胡 楠  卢 茜  郄淑燕  刘 畅  毕 胜
解放军医学院,北京市,100853
基金项目:
DOI:
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摘要:
      摘要 目的: 观察踝关节牵伸训练对脑卒中患者下肢功能的疗效并讨论其机制。 方法:25例脑卒中患者随机分为12例跟腱牵伸组(试验组)和13例直腿抬高组(对照组),两组均采用多关节下肢康复机器人系统LR2进行为期2周训练,共12次,每次45min。训练前后采用等速测试系统进行实验室评定踝关节被动峰力矩、踝关节主动峰力矩、踝关节主动、被动活动范围(passive range of motion, PROM)、力矩-角速度斜率(SLOPE);临床评定改良Ashworth量表(modified Ashworth scale, MAS)、临床痉挛指数(clinical spasticity index, CSI)。 结果: 训练前两组患者的一般资料、实验室及临床各项评定结果无显著性差异(P>0.05)。训练2周后,两组间踝关节被动峰力矩在角速度10°/s、60°/s、120°/s、180°/s差异有显著性意义(P<0.05),240°/s时无显著性差异(P>0.05);踝关节主动峰力矩在角速度60°/s两组间差异有显著性意义(P<0.05),120°/s、180°/s无显著性差异(P>0.05),SLOPE训练后两组间有显著性差异(P<0.05);试验组AROM、PROM、MAS、CSI改善情况明显优于对照组,差异有显著性意义(P<0.05)。 结论: 踝关节牵伸训练有效降低脑卒中患者痉挛,改善关节活动度,提高肌肉力量,是一种较为有效的治疗手段。
关键词:牵伸训练  痉挛  脑卒中  踝关节  关节活动度  肌力
Research on the effects of ankle stretch training on spasticity in patients with stroke:A randomized clinical trial    Download Fulltext
Dept. of Rehabilitation Medicine, Chinese PLA Medical School,100853
Fund Project:
Abstract:
      Abstract Objective: To observe the effects of ankle stretch training on lower limb function in stroke patients and to explore its mechanism. Method: Twenty-five patients with stroke were randomly divided into two groups: 12 in ankle stretching group (experimental group) and 13 in straight leg raising group (control group). Both groups were trained by the leg rehabilitation robot(LR2) for 2 weeks, 12 sessions in total, 45 min/session. Before and after training, the spasticity of the ankle joint was assessed by isokinetic testing system.; Active peak torque (PT) of ankle joint muscle was also tested. Besides the active and passive range of motion (AROM, PROM) of the ankle, torque- angular velocity slope(SLOPE), modified Ashworth scale (MAS), clinical spasticity index (CSI) were tested also. Result: Before training, there was no significant difference between two groups in all the measured parameters. After 2 weeks training, the spasticity measured under different angular velocity showed a significant difference between the two groups except 240 °/s. There was significant difference between the two groups in muscle strength at 60°/s , but not at 120°/s and 180°/s. Also, there was significant difference between the two groups in the SLOPE. The AROM, PROM, MAS value and CSI in experimental group were significantly better than control group(P<0.05). Conclusion: Ankle stretch training could effectively reduce spasticity in patients with stroke. Ankle joint mobility and its muscle strength might be improved also.
Keywords:stretch training  spasticity  stroke  ankle joint  range of motion  muscle strength
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