脑卒中患者双侧肢体训练的运动功能康复效果
发布时间：2018-11-19 09:57
【摘要】：目的探讨双侧肢体训练对脑卒中患者运动功能恢复的效果。方法按照入选标准和排除标准选取2015年10月至2016年9月华北理工大学附属医院康复医学科收治的60例脑卒中偏瘫患者,将入选病例按病变性质分层,层内按单纯随机法(随机数字表法)进行分组,每组30例,偶数为单侧训练组,进行传统的患侧肢体康复训练,奇数为双侧训练组,进行双侧肢体训练。双侧训练组进行常规康复训练和健侧肢体的康复训练。两组患者训练的时间频率相同,每次训练45分钟(单侧训练组只训练患肢,双侧训练组进行30分钟的患侧训练,再进行15分钟的健侧肢体训练),每天训练1次,每周5天,连续4周。采用运动功能评定量表(MAS)、Fugl-Meyer运动功能评分量表(FMA)以及DELSYS表面肌电图仪的最大自主收缩值(MVC)、随意收缩状态下的积分肌电(i EMG)以及均方根(RMS)在训练前和四周后进行测量,来评估患者的康复效果。表面肌电测试脑卒中患者患侧三角肌、肱二头肌、肱三头肌、股直肌、股二头肌和胫前肌。结果1治疗前MAS评分双侧训练组与单侧训练组相比,无显著性差异(P0.05),表明两组在入组时MAS具有可比性。经过四周的康复训练,两组患者MAS得分较治疗前显著提高(P0.05),且双侧训练组分数提高幅度大于单侧训练组(P0.05)。2治疗前双侧训练组和单侧训练组患者FMA评分比较无显著性差异(P0.05),经四周康复训练后,两组患者FMA得分较治疗前明显提高(P0.05),双侧训练组提高值虽大于单侧训练组,但两组分数提高值比较无明显差异(P=0.185)。3治疗前两组患者患侧三角肌、肱二头肌、肱三头肌、股直肌、股二头肌和胫前肌的MVC比较无明显差异(P0.05),四周的康复训练后,两组患者的三角肌、肱二头肌、肱三头肌、股直肌、股二头肌和胫前肌的MVC较治疗前明显提高(P0.05),双侧训练组这六块肌肉MVC提高幅度优于单侧训练组(P0.05)。4治疗前双侧训练组和单侧训练组患者患侧三角肌、肱二头肌、肱三头肌、股直肌、股二头肌和胫前肌的i EMG比较无明显差异(P0.05),四周的康复训练后,两组患者患侧三角肌、肱二头肌、肱三头肌、股直肌、股二头肌和胫前肌的i EMG较治疗前明显升高(P0.05),双侧训练组这六块肌肉i EMG的提高幅度大于单侧训练组(P0.05)。5治疗前双侧训练组和单侧训练组患者患侧三角肌、肱二头肌、肱三头肌、股直肌、股二头肌和胫前肌的RMS比较无明显差异(P0.05),四周的康复训练后,两组患者患侧三角肌、肱二头肌、肱三头肌、股直肌、股二头肌和胫前肌的RMS值较治疗前明显提高(P0.05),双侧训练组这六块肌肉RMS提高幅度大于单侧训练组(P0.05)。结论脑卒中患者的双侧肢体训练可促进其运动功能恢复,且效果优于传统患侧肢体训练,对脑卒中患者进行健侧肢体训练有助于患侧肢体运动功能的恢复。
[Abstract]:Objective to investigate the effect of bilateral limb training on motor function recovery in stroke patients. Methods from October 2015 to September 2016, 60 patients with stroke hemiplegia treated in the Department of Rehabilitation Medicine, affiliated Hospital of Huabei Polytechnic University, were selected according to the selection criteria and exclusion criteria. The selected cases were stratified according to the nature of the lesion. There were 30 cases in each group, the even number was one side training group, the traditional rehabilitation training of the affected side limbs was carried out, the odd number was bilateral training group, and the bilateral limb training group was carried out. Bilateral training group received routine rehabilitation training and contralateral limb rehabilitation training. The two groups were trained for 45 minutes each time (the unilateral training group only trained the affected limbs, the bilateral training group carried out 30 minutes of diseased side training and 15 minutes of healthy limb training), and the patients were trained once a day, 5 days a week. 4 weeks in a row. Using the motor function rating scale (MAS), Fugl-Meyer motor function scale (FMA) and the DELSYS surface electromyography to measure the maximum spontaneous contraction value (MVC), The integral electromyoelectric (i EMG) and root mean square (RMS) (RMS) were measured before and four weeks after training to evaluate the rehabilitation effect of the patients. Surface electromyography was performed on the affected deltoid, biceps, triceps, rectus femoris, biceps femoris and anterior tibial muscles of stroke patients. Results 1 there was no significant difference in MAS score between the bilateral training group and the unilateral training group before treatment (P0.05), indicating that MAS was comparable between the two groups when entering the group. After four weeks of rehabilitation training, the MAS scores of the two groups were significantly higher than those before treatment (P0.05). The scores of bilateral training group were significantly higher than that of unilateral training group (P0.05). 2 there was no significant difference in FMA score between bilateral training group and unilateral training group before treatment (P0.05). The FMA score of the two groups was significantly higher than that of the control group (P0.05). Although the improvement value of bilateral training group was higher than that of the unilateral training group, there was no significant difference between the two groups (P < 0.185). There was no significant difference in MVC between biceps, triceps, rectus, biceps, biceps and anterior tibialis (P0.05). After four weeks of rehabilitation training, the deltoid, biceps, triceps, rectus femoris, and rectus femoris were found in the two groups. The MVC of biceps femoris and anterior tibialis muscle was significantly higher than that of pre-treatment (P0.05). The increase of MVC in bilateral training group was better than that in unilateral training group (P0.05). The I EMG of biceps, triceps, rectus, biceps, biceps and anterior tibial muscles were not significantly different (P0.05). After four weeks of rehabilitation training, the patients in the two groups suffered from bilateral deltoid muscle, biceps brachii muscle, triceps brachii muscle, rectus femoris muscle. I EMG of biceps femoris and anterior tibialis muscle was significantly higher than that before treatment (P0.05). The increase of I EMG in these six muscles in bilateral training group was higher than that in unilateral training group (P0.05). 5 patients in bilateral training group and unilateral training group had affected deltoid muscle, biceps brachii muscle, triceps muscle, rectus femoris muscle before treatment. There was no significant difference in RMS between biceps femoris muscle and anterior tibial muscle (P0.05). After four weeks of rehabilitation training, the patients in the two groups suffered from bilateral deltoid muscle, biceps brachii muscle, triceps brachii muscle, rectus femoris muscle. The RMS value of biceps femoris and anterior tibialis muscle was significantly higher than that before treatment (P0.05). The increase of RMS in bilateral training group was higher than that in unilateral training group (P0.05). Conclusion bilateral limb training can promote the recovery of motor function in stroke patients, and the effect is better than that of traditional limb training.
【学位授予单位】：华北理工大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R743.3
本文编号：2341945
[Abstract]:Objective to investigate the effect of bilateral limb training on motor function recovery in stroke patients. Methods from October 2015 to September 2016, 60 patients with stroke hemiplegia treated in the Department of Rehabilitation Medicine, affiliated Hospital of Huabei Polytechnic University, were selected according to the selection criteria and exclusion criteria. The selected cases were stratified according to the nature of the lesion. There were 30 cases in each group, the even number was one side training group, the traditional rehabilitation training of the affected side limbs was carried out, the odd number was bilateral training group, and the bilateral limb training group was carried out. Bilateral training group received routine rehabilitation training and contralateral limb rehabilitation training. The two groups were trained for 45 minutes each time (the unilateral training group only trained the affected limbs, the bilateral training group carried out 30 minutes of diseased side training and 15 minutes of healthy limb training), and the patients were trained once a day, 5 days a week. 4 weeks in a row. Using the motor function rating scale (MAS), Fugl-Meyer motor function scale (FMA) and the DELSYS surface electromyography to measure the maximum spontaneous contraction value (MVC), The integral electromyoelectric (i EMG) and root mean square (RMS) (RMS) were measured before and four weeks after training to evaluate the rehabilitation effect of the patients. Surface electromyography was performed on the affected deltoid, biceps, triceps, rectus femoris, biceps femoris and anterior tibial muscles of stroke patients. Results 1 there was no significant difference in MAS score between the bilateral training group and the unilateral training group before treatment (P0.05), indicating that MAS was comparable between the two groups when entering the group. After four weeks of rehabilitation training, the MAS scores of the two groups were significantly higher than those before treatment (P0.05). The scores of bilateral training group were significantly higher than that of unilateral training group (P0.05). 2 there was no significant difference in FMA score between bilateral training group and unilateral training group before treatment (P0.05). The FMA score of the two groups was significantly higher than that of the control group (P0.05). Although the improvement value of bilateral training group was higher than that of the unilateral training group, there was no significant difference between the two groups (P < 0.185). There was no significant difference in MVC between biceps, triceps, rectus, biceps, biceps and anterior tibialis (P0.05). After four weeks of rehabilitation training, the deltoid, biceps, triceps, rectus femoris, and rectus femoris were found in the two groups. The MVC of biceps femoris and anterior tibialis muscle was significantly higher than that of pre-treatment (P0.05). The increase of MVC in bilateral training group was better than that in unilateral training group (P0.05). The I EMG of biceps, triceps, rectus, biceps, biceps and anterior tibial muscles were not significantly different (P0.05). After four weeks of rehabilitation training, the patients in the two groups suffered from bilateral deltoid muscle, biceps brachii muscle, triceps brachii muscle, rectus femoris muscle. I EMG of biceps femoris and anterior tibialis muscle was significantly higher than that before treatment (P0.05). The increase of I EMG in these six muscles in bilateral training group was higher than that in unilateral training group (P0.05). 5 patients in bilateral training group and unilateral training group had affected deltoid muscle, biceps brachii muscle, triceps muscle, rectus femoris muscle before treatment. There was no significant difference in RMS between biceps femoris muscle and anterior tibial muscle (P0.05). After four weeks of rehabilitation training, the patients in the two groups suffered from bilateral deltoid muscle, biceps brachii muscle, triceps brachii muscle, rectus femoris muscle. The RMS value of biceps femoris and anterior tibialis muscle was significantly higher than that before treatment (P0.05). The increase of RMS in bilateral training group was higher than that in unilateral training group (P0.05). Conclusion bilateral limb training can promote the recovery of motor function in stroke patients, and the effect is better than that of traditional limb training.
【学位授予单位】：华北理工大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R743.3
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