繩帶療法對腦卒中后偏癱患者異常步態和下肢功能改善作用

周慧青 王傳敏 俞建松

[摘要] 目的 探討繩帶療法對腦卒中后偏癱患者異常步態和下肢功能的改善作用。 方法 選擇2018年4月～2019年4月期間我院康復科進行康復治療的腦卒中后偏癱患者90例，采用拋銀幣法分為康復組與對照組，各45例。兩組患者均酌情予控制顱內壓、血壓、血糖和血脂，營養神經細胞及預防并發癥等常規治療。對照組患者予以常規康復訓練方法，康復組患者在對照組基礎上加用繩帶療法。兩組均干預8周。評估兩組患者干預前后步態參數（步長、步寬和步速）、下肢運動功能及日常生活能力的變化。 結果 干預8周后，兩組患者平均步長、步寬和步速較前明顯升高（P<0.05或P<0.01），且康復組升高幅度較對照組更明顯（P<0.05）;兩組患者FMA-L評分和改良MBI評分較前明顯升高（P<0.05或P<0.01），且康復組升高幅度較對照組更明顯（P<0.05）。 結論 繩帶療法用于腦卒中后偏癱患者不僅可有效改善患者異常步態，而且可明顯改善患者下肢功能，提高其日常生活能力。

[關鍵詞] 腦卒中后偏癱;繩帶療法;異常步態;下肢運動功能

[Abstract] Objective To explore the improvement effect of rope therapy on abnormal gait and lower limb function in patients with post-stroke hemiplegia. Methods 90 patients with post-stroke hemiplegia who were undergoing rehabilitation treatment in the rehabilitation department of our hospital from April 2018 to April 2019 were selected. The patients were divided into the rehabilitation group and the control group by the coin flipping method， with 45 patients in each group. Patients in both groups were given routine treatments such as control of intracranial pressure， blood pressure， blood glucose and blood lipids， nutritional nerve cells and prevention of complications. Patients in the control group were given conventional rehabilitation training methods. Patients in the rehabilitation group were given rope therapy on the basis of the control group. Both groups were intervened for 8 weeks. Changes in gait parameters （step length， step width， and pace）， lower limb motor function， and daily living ability were evaluated before and after intervention in both groups of patients. Results After 8 weeks of intervention， the average step length， step width， and pace in both groups were significantly higher than before （P<0.05 or P<0.01）， and the improvement in the rehabilitation group was more significant than that in the control group （P<0.05）; the FMA-L score and modified MBI score in both groups were significantly higher than before （P<0.05 or P<0.01）， and the increase in the rehabilitation group was more significant than that in the control group （P<0.05）. Conclusion Rope therapy for patients with post-stroke hemiplegia can not only effectively improve the abnormal gait of patients， but also significantly improve the lower limb function and enhance patients' ability of daily living.

[Key words] Post-stroke hemiplegia; Rope therapy; Abnormal gait; Lower limb motor function

腦卒中是老年患者常見神經系統疾病，可引起患者中樞神經系統受損，治療后患者往往遺留肌痙攣、姿勢控制差等運動功能異常，導致步行功能障礙，影響其日常生活活動能力[1，2]。以往對腦卒中后偏癱常采用物理治療、運動療法、作業治療等多種方法進行治療，但臨床療效相對較有限[3，4]。繩帶療法是利用有彈性繃帶纏繞于患者肢體的不同部位，起到改善患者運動控制能力的一種康復訓練方法，對糾正腦卒中后偏癱患者異常步態具有一定的較好效果[5，6]。本研究觀察了繩帶療法對腦卒中后偏癱患者異常步態和下肢功能的改善作用，現報道如下。