生物谐振促进脑卒中步行功能的临床研究

发布时间：2018-11-13 13:50

【摘要】：目的生物谐振有助于改善脑卒中偏瘫患者下肢运动控制能力,通过评定下肢区域性振动前后患者步态、步行速度以及稳定性,明确该振动方式对改善脑卒中偏瘫患者步行能力的作用。对象与方法第一部分受试者为26名(男性17名、女性9名、年龄66.54±6.54岁)脑卒中偏瘫患者,实验中接受频率16Hz、振幅4mm的下肢区域性振动刺激,在10分钟刺激过程中保持坐位下安静状态,分别于振动开始前、振动后即刻进行小腿三头肌张力(改良Ashworth分级,MAS),3米计时起立行走时间(TUGT)和10米最大步行速度(MWST)评定。第二部分脑卒中偏瘫患者22名(男性16名、女性6名、年龄67+6.4岁),接受同实验第一部分一致的振动刺激(安静坐位下肢区域性振动刺激,频率16Hz、振幅4mmm),利用三维步态分析系统分别于振动开始前、振动后即刻采集受试者步态时间-空间参数。结果第一部分比较振动刺激前、振动后即刻的评定结果发现,TUGT平均值由(17.60±±7.33)s减少为(16.15±6.70)s,10mMWS平均值由(1.51±0.49)m/s提高为(1.62±0.53)m/s,并且两者差异均有统计学意义(P=0.037；P=0.002)；但小腿三头肌张力MAS评分没有显著性变化(P0.05)。第二部分经过振动刺激,受试者步态空间参数中患侧步长由(38.844±11.92)cm增加到(41.06±12.20)cm,患侧步宽由(18.91±4.01)cm减小到(17.93±3.61)cm,并且配对资料t检验结果提示两者差异均有统计学意义(P=0.02；P=0.005)；而时间参数中受试者初始双支撑相百分比则由(61.24±5.96)%减少到(58.50±7.05)%,配对资料t检验结果提示差异有统计学意义(P=0.011)；其余步行时-空参数变化无明显统计学差异(P0.05)。结论下肢区域性振动刺激可以即刻改善脑卒中患者的步态、步速及步行稳定性,促进脑卒中患者下肢运动功能提高。
[Abstract]:Objective to improve the motor control ability of lower extremity in stroke hemiplegic patients by biological resonance, and to evaluate the gait, walking speed and stability of patients before and after regional vibration of lower extremities. To clarify the effect of this vibration mode on improving the walking ability of stroke hemiplegic patients. Participants and methods 26 subjects (male 17, female 9; age 66. 54 卤6. 54) with stroke hemiplegia received regional vibration stimulation with frequency 16 Hz and amplitude 4mm in the first part of the experiment. During 10 minutes of stimulation, keep quiet in the sitting position and perform triceps muscle tension (modified Ashworth grading, MAS),) immediately before vibration and immediately after vibration. (TUGT) and (MWST) evaluation of maximum walking speed of 10 m. In the second part, 22 patients with hemiplegia (16 males and 6 females aged 67, 6.4 years) received the same vibration stimulation as the first part of the experiment (regional vibration stimulation of lower extremities in quiet sitting position, frequency 16 Hz, amplitude 4mmm). The three dimensional gait analysis system was used to collect the time and space parameters of the subjects' gait before and immediately after the vibration. Results in the first part, the mean value of TUGT was reduced from (17.60 卤7.33) s to (16.15 卤6.70) s. The average value of 10mMWS increased from (1.51 卤0.49) m / s to (1.62 卤0.53) m / s, and the difference was statistically significant (P < 0.037). But there was no significant change in MAS score of triceps muscle tension (P0.05). In the second part, after vibration stimulation, the step length of the affected side increased from (38.844 卤11.92) cm to (41.06 卤12.20) cm, and the width of the affected side step decreased from (18.91 卤4.01) cm to (17.93 卤3.61) cm,. The results of t test of paired data showed that there was significant difference between the two groups (P0. 02, P < 0. 02). The percentage of initial bisupporting phase decreased from (61.24 卤5.96)% to (58.50 卤7.05)% in the time parameters, and the difference was statistically significant (P0.011). There was no significant difference between the other walking time and space parameters (P0.05). Conclusion the regional vibration stimulation of lower extremity can improve the gait, walking speed and walking stability of stroke patients immediately, and promote the improvement of motor function of lower extremities in stroke patients.
【学位授予单位】：南京医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R743.3

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