川平法联合减重步行训练对脑卒中足下垂患者下肢功能康复的疗效研究

Effectiveness of Chuān Píng method combined with weight-supported treadmill training for lower limb rehabilitation in patients with post-stroke foot drop

摘要:

目的 探究川平法联合减重步行训练对脑卒中足下垂患者下肢功能康复的疗效。方法 选取2020年3月—2023年3月榆林市第一医院康复医学科接收的96例脑卒中后足下垂患者作为研究对象。通过随机数字表法分为对照组（接受减重步行训练）和观察组（在对照组基础上接受川平法治疗），各48例。比较两组患者治疗前后的关节活动度、下肢肌力［徒手肌力评估（MMT）］、肌张力［Ashworth量表（MAS）］、下肢功能［Fugl-Meyer运动功能量表（FMA）、最小足廓清（MTC）］、平衡能力［Berg平衡功能量表（BBS）］、步行能力［Holden功能性步行分级（FAC）］、生活活动能力［Barthel指数］。结果 观察组治疗前后踝关节背屈度数、足下垂度数和足内翻度数的差值均高于对照组（P <0.05）。观察组治疗前后MMT和MAS评分的差值均高于对照组（P <0.05）。观察组治疗前后FMA和MTC的差值均高于对照组（P <0.05）。观察组治疗前后BBS和FAC评分的差值均高于对照组（P <0.05）。观察组治疗前后Barthel指数的差值高于对照组（P <0.05）。结论 川平法联合减重步行训练对脑卒中足下垂患者的下肢功能康复具有显著效果，能有效提高患者的下肢运动能力和日常生活能力，适合临床推广应用。

Abstract:

Objective This study aimed to explore the therapeutic effectiveness of Chuān Píng method combined with weight-supported treadmill training for the rehabilitation of lower limb functions in patients with post-stroke foot drop.Methods From March 2020 to March 2023, the 96 patients with post-stroke foot drop were selected from the Department of Rehabilitation Medicine at Yulin First Hospital. Using the random number table method, patients were divided into a control group (n = 48, receiving weight-supported treadmill training) and an observation group (n = 48, receiving Chuān Píng method treatment in addition to weight-supported treadmill training). Comparisons were made between the two groups on joint range of motion, lower limb muscle strength [manual muscle testing (MMT)], muscle tone [modified Ashworth scale (MAS)], lower limb function [Fugl-Meyer Assessment (FMA), minimum toe clearance (MTC)], balance performance [Berg balance scale (BBS)], walking ability [Functional Ambulation Category (FAC)], and activities of daily living (Barthel index) before and after treatment.Results The differences of ankle dorsiflexion angle, foot drop severity, and foot inversion angle before and after treatment were significantly greater in the observation group than in the control group (P < 0.05). The observation group showed significantly larger pre-to-post treatment changes in MMT and MAS scores (P < 0.05). Similarly, the improvement magnitudes of FMA and MTC scores after treatment were significantly higher in the observation group (P < 0.05). Greater differences in BBS and FAC before and after treatment were observed in the observation group compared with the control group (P < 0.05). The difference of the Barthel index before and after treatment in the observation group was also higher than that in the control group (P < 0.05).Conclusion The Chuān Píng method combined with weight-supported treadmill training demonstrates significant effects on the rehabilitation of lower limb functions in patients with post-stroke foot drop. It can effectively enhance patients' lower limb motor function and activities of daily living, making it suitable for clinical promotion and application.