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骨盆稳定性训练对脑卒中后运动控制、髋部肌肉力量、步行速度及日常活动的影响:一项随机对照试验

Effects of Pelvic Stability Training on Movement Control, Hip Muscles Strength, Walking Speed and Daily Activities after Stroke: A Randomized Controlled Trial.

作者信息

Dubey Lavnika, Karthikbabu Suruliraj, Mohan Divya

机构信息

Department of Physiotherapy, School of Allied Health Sciences (SOAHS), Bangalore Campus, Manipal University, Bangalore, India.

出版信息

Ann Neurosci. 2018 Jul;25(2):80-89. doi: 10.1159/000486273. Epub 2018 Jan 25.

Abstract

BACKGROUND

Pelvic instability is a common occurrence during standing and walking post stroke. Inappropriate muscle activation and poor movement control around the pelvis lead to difficulty in mobility and daily functioning.

PURPOSE

The purpose of the study was to examine the effects of pelvic stability training on the movement performance of trunk and lower limb, hip muscles strength, walking speed and daily activities after stroke.

METHODS

This randomized controlled trial involved 34 patients aged 56 (11) years with the post stroke duration being 31 (22) weeks. Patients with medical stability, an ability to follow verbal instructions, independent sitting balance and supervised walking capacity were included. The experimental group ( = 13) underwent the pelvic stability training and the control group ( = 13) were subjected to standard physiotherapy for 1 h a day, 3 times a week for over 6 weeks in a stroke rehabilitation setting. Trunk Impairment Scale 2.0 (TIS 2.0), Fugl Meyer Assessment of Lower Extremity (FMA-LE), hip muscles strength (lb.), gait speed, pelvic tilt and modified Barthel Index (MBI) were the outcome measures.

RESULTS

All the measures between both groups were similar at baseline except TIS 2.0 and FMA-LE. Following training, pelvic stability group showed statistically significant improvement ( < 0.05) except MBI and substantial mean changes in the measures of TIS 2.0 (2.12), FMA-LE (5.12), hip strength (lb.) for flexors (4.6), extensors (2.8), abductors (2.58), adductors (2.9), gait speed (0.05 m/s) and MBI (7.74) as against standard physiotherapy group.

CONCLUSION

Pelvic stability training was found to be beneficial in improving the trunk and lower extremity movement control, hip muscles strength, gait speed and daily activities in stroke.

摘要

背景

中风后站立和行走时骨盆不稳定是常见现象。骨盆周围肌肉激活不当和运动控制不佳会导致行动和日常功能出现困难。

目的

本研究旨在探讨骨盆稳定性训练对中风后躯干和下肢运动表现、髋部肌肉力量、步行速度及日常活动的影响。

方法

本随机对照试验纳入了34例年龄为56(11)岁、中风后病程为31(22)周的患者。纳入的患者需病情稳定、能听从口头指令、具备独立坐位平衡及在监督下行走的能力。实验组(n = 13)接受骨盆稳定性训练,对照组(n = 13)在中风康复环境中每天接受1小时标准物理治疗,每周3次,持续6周以上。采用躯干功能障碍量表2.0(TIS 2.0)、下肢Fugl Meyer评估量表(FMA - LE)、髋部肌肉力量(磅)、步速、骨盆倾斜度及改良Barthel指数(MBI)作为观察指标。

结果

除TIS 2.0和FMA - LE外,两组间所有指标在基线时相似。训练后,与标准物理治疗组相比,骨盆稳定性训练组除MBI外,在TIS 2.0(2.12)、FMA - LE(5.12)、髋部屈肌力量(磅)(4.6)、伸肌力量(2.8)、外展肌力量(2.58)、内收肌力量(2.9)、步速(0.05 m/s)及MBI(7.74)等指标上均有统计学意义的显著改善(P < 0.05),且各指标有显著的平均变化。

结论

研究发现骨盆稳定性训练有助于改善中风患者的躯干和下肢运动控制、髋部肌肉力量、步速及日常活动能力。

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