跷脉针刺联合对称负重式训练对脑卒中偏瘫患者肌张力、足内翻角及坐站转移能力的影响OACSTPCD
Impacts of Qiao channel acupuncture combined with symmetrical weight-bearing training on muscle tension,foot varus angle,and sitting-standing transfer ability in patients with hemiplegia after stroke
目的:探讨跷脉针刺联合对称负重式训练对脑卒中偏瘫患者肌张力、足内翻角及坐站转移能力的影响.方法:选取2021年3月～2022年4月本院收治的130例脑卒中后痉挛性偏瘫(SPAS)患者,并采用随机数字表法分成训练组和研究组各65例.训练组开展对称负重式训练,研究组在训练组基础上实施跷脉针刺干预.比较2组干预前、干预6周后下肢肌张力[采用改良Ashworth分级(MAS)]、痉挛状况[采用综合痉挛量表(CSS)]、步态参数、足内翻角、坐站转移能力[5次坐立测试(FTSST)]及下肢功能[采用Fugl-meyer评定量表(FMA)].结果:干预6周后,2组下肢MAS分级均优于干预前(P＜0.05),且研究组下肢MAS分级优于训练组(P＜0.05);2组CSS评分及5次坐立测试(FTSST)数值均低于干预前(P＜0.05),且研究组均低于训练组(P＜0.05);2组步速均大于干预前(P＜0.05),且研究组大于训练组(P＜0.05);2组步宽、步态周期、支撑相时间、步长偏差、足内翻角均小于干预前(P＜0.05),且研究组均小于训练组(P＜0.05);2组FMA下肢评分均高于干预前(P＜0.05),且研究组高于训练组(P＜0.05).结论:对SPAS患者实施跷脉针刺联合对称负重式训练,可有效改善下肢肌张力、痉挛状况及步态,显著提高坐站转移能力及下肢功能.
Objective:To explore the impacts of Qiao channel acupuncture combined with symmetrical weight bear-ing training on muscle tension,foot varus angle,and sitting-standing transfer ability in patients with hemiplegia af-ter stroke.Methods:A total of 130 patients with spastic paralysis after stroke(SPAS)admitted to our hospital from March 2021 to April 2022 were selected and randomly grouped into training group(n=65)and research group(n=65)using a digital table method.The training group was given symmetrical weight bearing training,and the re-search group was subjected to Qiao channel acupuncture intervention on the basis of the training group.The lower limb muscle tone[modified Ashworth scale(MAS)],spasticity status[comprehensive spasticity scale(CSS)],gait parameters,foot varus angle,sitting and standing transfer ability[Five-Times-Sit-to-Stand Test(FTSST)],and lower limb function[Fugl-Meyer Assessment(FMA)]were compared between the two groups before and after 6 weeks of intervention.Results:After 6 weeks of intervention,the lower limb MAS grading in both groups was bet-ter than before intervention(P＜0.05),and the lower limb MAS in the study group was better than that in the training group(P＜0.05).The CSS scores and FTSST value in both groups were lower than those before interven-tion(P＜0.05),and those in the research group were lower than those in the training group(P＜0.05).The walk-ing speed in both groups was faster than before intervention(P＜0.05),and that in the research group was faster than in the training group(P＜0.05).The stride width,gait cycle,support phase time,stride deviation,and foot varus angle in the two groups were significantly decreased as compared with those before intervention(P＜0.05),and those in the research group were significantly reduced as compared with those in the training group(P＜0.05).The lower limb FMA score in both groups was higher than before intervention(P＜0.05),and that in the research group was higher than in the training group(P＜0.05).Conclusion:Applying Qiao channel acupuncture combined with symmetrical weight bearing training to patients with SPAS can effectively improve the muscle tension and spasticity of the lower limbs,greatly im-prove the sitting-standing transfer ability and lowerlimb function.
巴焕;李宁;吴仪
河南省中西医结合医院康复医学科,郑州 450000
临床医学
跷脉针刺对称负重式训练脑卒中偏瘫肌张力坐站转移能力
Qiao channel acupuncturesymmetrical weight bearing trainingstrokehemiplegiamuscle tensionstation transfer capability
《中国康复》 2024 (001)
17-21 / 5
河南省中医药科学研究专项课题(2019ZY2105)
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