CAJ | 학술논문

目的：观察早期下肢智能反馈康复训练系统对卒中偏瘫患者步行能力的影响。方法纳入发病时间＜1个月的首次卒中后偏瘫患者40例，按入院编号的奇偶数分为试验组和对照组各20例。于病情稳定48 h后开始康复训练。对照组给予常规康复训练，试验组在此基础上采用下肢智能反馈康复训练系统进行步行能力训练。采用 Fugl-Meyer运动功能量表（下肢部分， FMA-L）、Holden步行功能分级评估患者的下肢运动及步行能力；采用表面肌电评估胫前肌、腓肠肌的肌张力、肌力变化情况。结果治疗前，两组的FMA-L评分、Holden步行功能分级评定差异无统计学意义（P＞0.05）。治疗后4周，试验组和对照组的FMA-L评分均较治疗前改善（P＜0.01）；两组治疗前后差值分别为（20.0±6.2）、（5.1±1.6）分，试验组的改善程度优于对照组（P＜0.01）。Holden步行功能分级仅试验组较治疗前改善（P＜0.01）。两组治疗前胫前肌和腓肠肌的肌力、肌张力差异无统计学意义（P＞0.05）。治疗后4周，两组均较治疗前好转（P＜0.01），其中试验组胫前肌肌力、肌张力治疗前后的差值分别为（20±7）、（12±4）μV，对照组分别为（12±4）、（9±3）μV；试验组腓肠肌肌力、肌张力治疗前后的差值分别为（25±8）、（19±6）μV，对照组分别为（10±3）、（11±2）μV。试验组与对照组比较，差异均有统计学意义（P＜0.01）。结论早期下肢智能反馈康复训练系统的治疗能显著改善卒中偏瘫患者的下肢步行能力。
목적：관찰조기하지지능반궤강복훈련계통대졸중편탄환자보행능력적영향。방법납입발병시간＜1개월적수차졸중후편탄환자40례，안입원편호적기우수분위시험조화대조조각20례。우병정은정48 h후개시강복훈련。대조조급여상규강복훈련，시험조재차기출상채용하지지능반궤강복훈련계통진행보행능력훈련。채용 Fugl-Meyer운동공능량표（하지부분， FMA-L）、Holden보행공능분급평고환자적하지운동급보행능력；채용표면기전평고경전기、비장기적기장력、기력변화정황。결과치료전，량조적FMA-L평분、Holden보행공능분급평정차이무통계학의의（P＞0.05）。치료후4주，시험조화대조조적FMA-L평분균교치료전개선（P＜0.01）；량조치료전후차치분별위（20.0±6.2）、（5.1±1.6）분，시험조적개선정도우우대조조（P＜0.01）。Holden보행공능분급부시험조교치료전개선（P＜0.01）。량조치료전경전기화비장기적기력、기장력차이무통계학의의（P＞0.05）。치료후4주，량조균교치료전호전（P＜0.01），기중시험조경전기기력、기장력치료전후적차치분별위（20±7）、（12±4）μV，대조조분별위（12±4）、（9±3）μV；시험조비장기기력、기장력치료전후적차치분별위（25±8）、（19±6）μV，대조조분별위（10±3）、（11±2）μV。시험조여대조조비교，차이균유통계학의의（P＜0.01）。결론조기하지지능반궤강복훈련계통적치료능현저개선졸중편탄환자적하지보행능력。
Objective To observe the effects of early intelligent feedback rehabilitation training system of lower extremities on walking ability in stroke patients with hemiplegia. Methods Forty post-stroke hemiplegic patients (onset <1 month)were enrolled. They were randomly divided into either an intelligent feedback rehabilitation group or a conventional rehabilitation group by the admission numbers (n=20 in each group). The rehabilitation training began at 48 hours after patient′s condition stabled. The conventional rehabilitation group received conventional rehabilitation training only,and on this basis,the patients of intelligent rehabilitation group underwent walking ability training using intellectual feedback rehabilitation training system of lower extremities. The walking ability of lower-extremity of the patients was evaluated with the Fugl-Meyer Assessment Scale (FMA-L)and Holden Walking Classification. The changes of the tension and strength of tibialis anterior muscle and gastrocnemius muscle were evaluated by the surface myoelectric signals. Results Before treatment,there were no significant differences in FMA-L scores and Holden walking function classification between the two groups (P>0. 05). Four weeks after treatment, the FMA-L scores were improved in both the intelligent and conventional rehabilitation groups compared to before treatment (P<0. 01);the differences were 20. 0 ± 6. 2 and 5. 1 ± 1. 6 respectively before and after treatment. The degree of improvement of the intelligent rehabilitation group was better than that of the conventional rehabilitation group (P<0. 01). Holden walking function classification showed that only the intelligent rehabilitation group was improved as compared to before treatment (P<0. 01). Four weeks after treatment ,the strength and tone of the tibialis anterior muscle and gastrocnemius muscle of both groups were increased compared to before treatment (P <0. 01 ). The differences of the strength and tone of the tibialis anterior muscle were 20 +7 and 12 +4μV respectively in the rehabilitation groups before and after treatment,and those were 12+4 and 9+3μV in the conventional rehabilitation group;the differences of the strength and tone of the gastrocnemius muscle of the intelligent rehabilitation group were 25+8 and 19+6μV respectively before and after treatment,and those of the conventional rehabilitation group were 10+3 and 11+2μV respectively. There was significant difference between the intelligent rehabilitation group and the conventional rehabilitation group (P <0. 01 ). Conclusion The treatment of early intelligent feedback rehabilitation training system of the lower extremities may significantly improve the walking ability of the lower extremities in stroke patients with hemiplegia.