CAJ | 학술논문

目的：观察神经肌肉本体感觉促进技术（ PNF）结合康复疗法治疗脊髓损伤合并不完全性截瘫的临床疗效。方法脊髓损伤合并不全截瘫患者90例，以年龄不同分为青少年组28例、中年组33例、老年组29例。患者均做脊髓减压、脊柱内固定手术治疗，手术后1～2周进行康复治疗。康复治疗方法包括常规运动疗法、针灸、高压氧及PNF治疗。3组在康复治疗前、治疗后3个月用Frankel脊髓损伤分级、中国脊髓损伤协会评分标准进行感觉及运动评分，改良巴氏指数（ MBI ）评定表评定日常生活活动能力。结果3组患者康复治疗后Frankel 分级与治疗前比较，中年组差异有统计学意义（P＜0．05），其余两组差异无统计学意义（P＞0．05）。 ASIA感觉评分、运动评分、MBI均较治疗前明显提高（ P＜0．05）。康复治疗后，中年组感觉评分、运动评分增加幅度明显大于老年组（P＜0．05），但与青少年组无明显差异（P＞0．05）。结论 PNF技术结合康复疗法对不同年龄患者疗效基本相同，其对于中年患者疗效是否更为显著有待进一步研究。
목적：관찰신경기육본체감각촉진기술（ PNF）결합강복요법치료척수손상합병불완전성절탄적림상료효。방법척수손상합병불전절탄환자90례，이년령불동분위청소년조28례、중년조33례、노년조29례。환자균주척수감압、척주내고정수술치료，수술후1～2주진행강복치료。강복치료방법포괄상규운동요법、침구、고압양급PNF치료。3조재강복치료전、치료후3개월용Frankel척수손상분급、중국척수손상협회평분표준진행감각급운동평분，개량파씨지수（ MBI ）평정표평정일상생활활동능력。결과3조환자강복치료후Frankel 분급여치료전비교，중년조차이유통계학의의（P＜0．05），기여량조차이무통계학의의（P＞0．05）。 ASIA감각평분、운동평분、MBI균교치료전명현제고（ P＜0．05）。강복치료후，중년조감각평분、운동평분증가폭도명현대우노년조（P＜0．05），단여청소년조무명현차이（P＞0．05）。결론 PNF기술결합강복요법대불동년령환자료효기본상동，기대우중년환자료효시부경위현저유대진일보연구。
Objective To investigate the clinical effects of proprioceptive neuromuscular facilitation ( PNF) technique combined with rehabilitation therapy on patients of different ages with spinal cord injury and complicated by incomplete paraplegia .Methods Ninety patients with spinal cord injury and complicated by incomplete paraplegia were selected and divided into the young group ( n =28 ) , middle-aged group ( n =33 ) and elderly group ( n =29 ) according to their ages.All patients received spinal cord decompression and vertebral internal fixation ,and the rehabilitation therapy including routine exercise therapy ,acupuncture ,hyperbaric oxygen and PNF technique which was performed 1-2 weeks after surgery .The patients′Frankel grade for spinal cord injury as well as ASIA scores for sensory and motion function were obtained before and 3 months after rehabilitation treatment among three groups ,and the activities of daily life function were assessed by using modified Barthel index(MBI).Results With regard to Frankel classification,the difference between the pre-therapy grade and post-therapy grade in the middle-aged group was statistically significant(P<0.05),but the differences in the other two groups were not statistically significant (P>0.05).The post-therapy ASIA scores for sensory and motion function as well as MBI index increased significantly in contrast with the pre -therapy ones(P<0.05).After rehabilitation treatment , the increase of ASIA scores for sensory and motion function showed a significant difference between middle-aged group and elderly group(P<0.05),but showed no significant difference between middle-aged group and young group(P>0.05).Conclusion PNF technique combined with rehabilitation therapy shows similar effects on patients of different ages .A further study is needed to confirm the better effects of the therapy on middle-aged patients.