三维步态指导下的骨盆控制训练对偏瘫患者的影响

doi:10.3760/cma.j.issn.1007-1245.2022.09.025

摘要/Abstract

摘要： 目的　探讨三维步态指导下的骨盆控制训练对于偏瘫患者的影响。方法　选取2019年5月至2020年9月于广东三九脑科医院接受治疗的48例偏瘫患者，并按照随机数字表法将其分为对照组与观察组，每组24例。对照组中，男13例，女11例，年龄（44.75±13.34）岁；观察组中，男14例，女10例，年龄（45.38±13.41）岁。对照组患者给予常规综合康复训练，观察组患者在此基础上增加三维步态指导下的骨盆控制训练，记录两组患者训练前后三维步态动力学参数、Holden功能性步行分级量表（FAC）及Berg平衡量表（Berg Balance Scale，BBS）评分，组间差异比较采用ANOVA检验法。结果　治疗前，两组患者的左右侧步长、左右下肢髋关节伸展峰值、左右下肢髋关节力矩高峰值、左右下肢髋关节力矩低峰值、FAC及BBS评分比较，差异均无统计学意义（均P>0.05）。治疗结束后，对照组、观察组患者的左右侧步长［分别为（0.545±0.08）m比（0.602±0.082）m，F=6.185，P=0.017；（0.587±0.115）m比（0.664±0.092）m，F=6.525，P=0.014］、左右下肢髋关节伸展峰值［分别为（6.87±2.17）比（8.92±2.53），F=8.972，P=0.004）；（6.79±2.36）比（11.00±2.45），F=36.757，P<0.001］、左右下肢髋关节力矩高峰值［分别为（0.427±0.037）比（0.508±0.066），F=27.921，P<0.001；（0.605±0.09）比（0.767±0.063），F=39.422，P<0.001］、左右下肢髋关节力矩低峰值［分别为（0.402±0.040）比（0.455±0.068），F=10.616，P=0.002；（0.442±0.037）比（0.497±0.063），F=13.565，P=0.001）］、FAC评分［（2.75±0.79）分比（3.75±0.94）分，F=15.771，P<0.001］及BBS评分［（48.90±3.74）分比（53.00±2.85）分，F=17.722，P<0.001］比较，差异均有统计学意义。结论　对偏瘫患者实施三维步态指导下的骨盆控制训练能够有效改善患者的步态能力。

关键词: 三维步态指导, 骨盆控制训练, 偏瘫, FAC评分, Berg量表评分

Abstract: Objective　To study the effect of three-dimensional gait guided pelvic control training for patients with spastic cerebral palsy. Methods　Forty-eight patients with spastic cerebral palsy treated at Guangdong 999 Brain Hospital from May 2019 to September 2020 were randomly divided into a control group and an observation group, with 24 cases in each group. There were 13 males and 11 females in the control group, and they were (44.75±13.34) years old. There were 14 males and 10 females in the observation group, and they were (45.38±13.41) years old. The control group did routine rehabilitation training, and the observation group did pelvic control training under the guidance of three-dimensional gait on the basis of control group. Before and after the treatment, the scores of 3D gait parameters, Functional Ambyiation Category Scale (FAC), and Berg Balance Scale (BBS) of the two groups were recorded and analyzed. ANOVA was used for the comparison between these two groups. Results　There were no statistical differences in the left and right step sizes, peak values of hip joint extension of left and right lower limbs, peak torques of hip joint of left and right lower limbs, low peak values of hip joint torque of left and right lower limbs, and scores of FAC and BBS between the two groups before the treatment (all P>0.05). After the treatment, there were statistical differences in the left and right step sizes [(0.545±0.08) m vs. (0.602±0.082) m, F=6.185, P=0.017; (0.587±0.115) m vs. (0.664±0.092) m, F=6.525, P=0.014], peak values of hip joint extension of left and right lower limbs [(6.87±2.17) vs. (8.92±2.53), F=8.972, P=0.004; (6.79±2.36) vs. (11.00±2.45), F=36.757, P<0.001], peak torques of hip joint of left and right lower limbs [(0.427±0.037) vs. (0.508±0.066), F=27.921, P<0.001; (0.605±0.09) vs. (0.767±0.063), F=39.422, P<0.001], low peak values of hip joint torque of left and right lower limbs [(0.402±0.040) vs. (0.455±0.068), F=10.616, P=0.002; (0.442±0.037) vs. (0.497±0.063), F=13.565, P=0.001], and scores of FAC [(2.75±0.79) vs. (3.75±0.94), F=15.771, P<0.001] and BBS [(48.90±3.74) vs. (53.00±2.85), F=17.722, P<0.001] between the control group and the observation group. Conclusion　Three-dimensional gait guided pelvic control training can improve the gait and lower limb movement function of patients with spastic cerebral palsy.

Key words: Three-dimensional gait, Pelvic control training, Spastic cerebral palsy, Score of FAC, Score of Berg Scale

刘展豪, 冯重睿, 鲁发华, 郭永亮, 刘初容.

三维步态指导下的骨盆控制训练对偏瘫患者的影响 [J]. 国际医药卫生导报, 2022, 28(9): 1292-1296.

Liu Zhanhao, Feng Chongrui, Lu Fahua, Guo Yongliang, Liu Churong. Effect of three-dimensional gait guided pelvic control training for patients with spastic cerebral palsy[J]. International Medicine and Health Guidance News, 2022, 28(9): 1292-1296.

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