CAJ | 학술논문

目的：探讨Biodex平衡训练系统辅助特定性平板步行训练对卒中后下肢运动功能的影响。方法选取卒中后平衡和下肢运动功能障碍的偏瘫患者40例，按病例号奇偶数分为平衡训练组和常规训练组，每组20例。常规训练组给予常规康复治疗及传统的平衡训练，平衡训练组在常规康复治疗的基础上，应用Biodex平衡训练系统辅助特定任务性平板步行训练。于治疗前及治疗后4周评价两组患者的下肢稳定性指数、Berg平衡量表评分（BBS）、“起立-行走”计时（TUGT）、最大步速和步长、Fugl-Meyer运动功能量表（下肢部分）评分（FMA-L）、改良Barthel指数（MBI）及功能性步行量表评分（FAC），综合评定患者的平衡和下肢运动功能。结果治疗前，两组患者的各项指标比较，差异均无统计学意义（P＞0.05）。治疗后，两组患者各项指标均较治疗前好转，差异有统计学意义（P＜0.01）；平衡训练组与常规训练组比较，稳定性指数（分别为6.5±1.3、8.5±2.1）、BBS评分[分别为（49±4）、（34±3）分]、TUGT[分别为（13.5±3.2）、（22.3±2.8）s]、最大步速[分别为（60±23）、（50±21）m/min]、最大步长[分别为（54±12）、（42±11）m]、FMA评分[分别为（31±4）、（24±5）分]、MBI评分[分别为（81±14）、（70±11）分]及FAC分级评分[分别为（4.31±0.39）、（3.21±0.19）分]改善程度均优于常规训练组，差异有统计学意义（P＜0.01或P＜0.05）。结论应用Biodex平衡训练系统辅助特定任务性平板步行训练对卒中后患者的平衡和下肢运动功能有很好的改善作用。
목적：탐토Biodex평형훈련계통보조특정성평판보행훈련대졸중후하지운동공능적영향。방법선취졸중후평형화하지운동공능장애적편탄환자40례，안병례호기우수분위평형훈련조화상규훈련조，매조20례。상규훈련조급여상규강복치료급전통적평형훈련，평형훈련조재상규강복치료적기출상，응용Biodex평형훈련계통보조특정임무성평판보행훈련。우치료전급치료후4주평개량조환자적하지은정성지수、Berg평형량표평분（BBS）、“기립-행주”계시（TUGT）、최대보속화보장、Fugl-Meyer운동공능량표（하지부분）평분（FMA-L）、개량Barthel지수（MBI）급공능성보행량표평분（FAC），종합평정환자적평형화하지운동공능。결과치료전，량조환자적각항지표비교，차이균무통계학의의（P＞0.05）。치료후，량조환자각항지표균교치료전호전，차이유통계학의의（P＜0.01）；평형훈련조여상규훈련조비교，은정성지수（분별위6.5±1.3、8.5±2.1）、BBS평분[분별위（49±4）、（34±3）분]、TUGT[분별위（13.5±3.2）、（22.3±2.8）s]、최대보속[분별위（60±23）、（50±21）m/min]、최대보장[분별위（54±12）、（42±11）m]、FMA평분[분별위（31±4）、（24±5）분]、MBI평분[분별위（81±14）、（70±11）분]급FAC분급평분[분별위（4.31±0.39）、（3.21±0.19）분]개선정도균우우상규훈련조，차이유통계학의의（P＜0.01혹P＜0.05）。결론응용Biodex평형훈련계통보조특정임무성평판보행훈련대졸중후환자적평형화하지운동공능유흔호적개선작용。
Objective To investigate the effects of Biodex system assisted task-specific walking training on lower limb motor function after stroke. Methods Forty hemiplegic patients with balance and lower limb motor dysfunction after stroke were enrolled. They were divided into either a balance training group or a control group according to their case numbers (n=20 in each group). The control group only received conventional rehabilitation treatment. On the basis of conventional rehabilitation treatment,the patients in the balance training group also received Biodex system assisted task-specific walking training. The stability index of lower-extremity,Berg Balance Scale (BBS)score,Timed Up and Go Test (TUGT), maximum walking speed and stride length,Fugl-Meyer Assessment (lower-extremity)(FMA-L)score, modified Barthel Index (MBI),and Functional Ambulation Categories (FAC)were used to evaluate the patients of both groups before treatment and 4 weeks after treatment. The balance and lower extremity motor function of the patients were assessed comprehensively. Results Before treatment,there were no significant differences in various indicators between the two groups (P>0. 05). After treatment,all the indicators were better than before treatment in both groups. There were significant differences (P<0. 01);the improvement degrees of the stability index (6. 5 ± 1. 3 vs. 8. 5 ± 2. 1),BBS score (49 ± 4 vs. 34 ± 3 min),TUGT (13. 5 ± 3. 2 s vs. 22. 3 ± 2. 8 s),maximum walking speed (60 ± 23 m/min vs. 50 ± 21 m/min),maximum stride length (54 ± 12 m vs. 42 ± 11 m),FMA score (31 ± 4 vs. 24 ± 5),MBI score (81 ± 14 vs. 70 ± 11), and FAC grading score (4. 31 ± 0. 39 vs. 3. 21 ± 0. 19)of the balance training group were all better than those of the control group. There were significant differences (P <0. 01 or P <0. 05 ). Conclusion Using Biodex system assisted task-specific walking training has a obvious improvement for the balance and lower limb motor function in patients after stroke.