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目的:针对脑卒中后偏瘫患者早期开展减重步行训练(partial body weight support treadmill training,PBWSTT)存在的膝、踝关节控制不良,采用靶向性训练,观察其对下肢运动功能、步行能力和ADL的影响。方法:选择病程在3个月内、偏瘫肢体Brunnstrom分期≥Ⅱ期的稳定性卒中患者28例作为试验组,均接受靶向性训练和PBWSTT训练。结果:两组患者经不同康复治疗后,治疗前后均有明显的差异。试验组FAC由治疗前0.37±0.14提高到治疗后3.9±1.2、FMA由治疗前21.8±6.3提高到治疗后42.5±7.6、FIM由治疗前33.8±3.3提高到治疗后86.8±9.6;对照组FAC由治疗前0.38±0.28提高到治疗后2.6±1.1、FMA由治疗前19.1±5.6提高到治疗后32.6±5.2、FIM由治疗前32.3±4.8提高到治疗后73.8±7.8。试验组FAC、FMA积分及FIM评分的改善情况明显优于对照组(P<0.05)。治疗后试验组患者的独立步行能力改善也明显优于对照组(P<0.05)。结论:减重步行结合靶向性膝踝控制训练有利于提高下肢运动功能、步行能力及ADL。
OBJECTIVE: To target the knee and ankle joints of partial body weight support treadmill (PBWSTT) in stroke-prone hemiplegic patients in early stage and to observe the effects on the motor function, walking ability and ADL Impact. Methods: 28 patients with stable stroke with stage Ⅱ Brunnstrom staging within 3 months were selected as the experimental group, and received targeted training and PBWSTT training. Results: Two groups of patients after different rehabilitation, before and after treatment were significantly different. FAC increased from 0.37 ± 0.14 before treatment to 3.9 ± 1.2 after treatment, FMA increased from 21.8 ± 6.3 before treatment to 42.5 ± 7.6 after treatment, FIM increased from 33.8 ± 3.3 before treatment to 86.8 ± 9.6 after treatment. In control group, FAC From 0.38 ± 0.28 before treatment to 2.6 ± 1.1 after treatment, FMA increased from 19.1 ± 5.6 before treatment to 32.6 ± 5.2 after treatment, FIM increased from 32.3 ± 4.8 before treatment to 73.8 ± 7.8 after treatment. The improvement of FAC, FMA score and FIM score of the experimental group was significantly better than that of the control group (P <0.05). After treatment, the improvement of independent walking ability of the test group was also better than that of the control group (P <0.05). CONCLUSION: Weight-reducing walking combined with targeted knee-ankle control training is beneficial to improving lower extremity motor function, walking ability and ADL.