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四周训练对慢性卒中患者进行踝关节活动度训练与静态肌肉拉伸的比较:一项随机对照试验。

Four-week training involving ankle mobilization with movement versus static muscle stretching in patients with chronic stroke: a randomized controlled trial.

作者信息

Park Donghwan, Lee Ji-Hyun, Kang Tae-Woo, Cynn Heon-Seock

机构信息

a Department of Physical Therapy, Graduate School , Yonsei University , Wonju , Republic of Korea.

出版信息

Top Stroke Rehabil. 2019 Mar;26(2):81-86. doi: 10.1080/10749357.2018.1550614. Epub 2018 Nov 26.

Abstract

BACKGROUND

Patients with stroke generally have diminished balance and gait. Mobilization with movement (MWM) can be used with manual force applied by a therapist to enhance talus gliding movement. Furthermore, the weight-bearing position during the lunge may enhance the stretch force.

OBJECTIVES

This study aimed to compare the effects of a 4-week program of MWM training with those of static muscle stretching (SMS). Ankle dorsiflexion passive range of motion (DF-PROM), static balance ability (SBA), the Berg balance scale (BBS), and gait parameters (gait speed and cadence) were measured in patients with chronic stroke.

METHODS

Twenty patients with chronic stroke participated in this study. Participants were randomized to either the MWM (n = 10) or the SMS (n = 10) group. Patients in both groups underwent standard rehabilitation therapy for 30 min per session. In addition, MWM and SMS techniques were performed three times per week for 4 weeks. Ankle DF-PROM, SBA, BBS score, and gait parameters were measured after 4 weeks of training.

RESULTS

After 4 weeks of training, the MWM group showed significant improvement in all outcome measures compared with baseline (p < 0.05). Furthermore, SBA, BBS, and cadence showed greater improvement in the MWM group compared to the SMS group (p < 0.05).

CONCLUSIONS

This study demonstrated that MWM training, combined with standard rehabilitation, improved ankle DF-PROM, SBA, BBS scores, and gait speed and cadence. Thus, MWM may be an effective treatment for patients with chronic stroke.

摘要

背景

中风患者通常平衡能力和步态会减弱。手法辅助下的关节活动技术(MWM)可通过治疗师施加的手动力量来增强距骨滑动运动。此外,弓步蹲时的负重姿势可能会增强拉伸力。

目的

本研究旨在比较为期4周的MWM训练计划与静态肌肉拉伸(SMS)的效果。对慢性中风患者测量踝关节背屈被动活动范围(DF-PROM)、静态平衡能力(SBA)、伯格平衡量表(BBS)和步态参数(步速和步频)。

方法

20例慢性中风患者参与本研究。参与者被随机分为MWM组(n = 10)或SMS组(n = 10)。两组患者均接受每次30分钟的标准康复治疗。此外,MWM和SMS技术每周进行3次,共4周。训练4周后测量踝关节DF-PROM、SBA、BBS评分和步态参数。

结果

训练4周后,MWM组与基线相比,所有结局指标均有显著改善(p < 0.05)。此外,与SMS组相比,MWM组的SBA、BBS和步频改善更明显(p < 0.05)。

结论

本研究表明,MWM训练结合标准康复可改善踝关节DF-PROM、SBA、BBS评分以及步速和步频。因此,MWM可能是慢性中风患者的一种有效治疗方法。

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