Chen Xiaofeng, Gan Zhuohui, Tian Wuchao, Lv Yongkai
Xiaofeng Chen, Department of Rehabilitation Medicine, Shenzhen Baoxing Hospital, Shenzhen 518115, P. R. China.
Zhuohui Gan, Department of Internal Medicine, The First Military Honor Rehabilitation Hospital of Guangdong, Guangzhou 510260, P. R. China.
Pak J Med Sci. 2020 Mar-Apr;36(3):461-466. doi: 10.12669/pjms.36.3.1466.
To evaluate the effects of rehabilitation training of core muscle stability on stroke patients with hemiplegia.
A total of 180 stroke patients who were hospitalized from December 2017 to December 2018 were enrolled. They were randomly divided into an observation group and a control group (n=90) that both received conventional hemiplegia rehabilitation therapy. On this basis, the observation group was subjected to training for core muscle stability, five times a week for a total of eight weeks. The balance functions before and after training were assessed using the Berg Balance Scale (BBS). The functions of hemiplegic lower limbs were evaluated by Brunnstrom staging and the Fugl-Meyer motor assessment (FMA) scale. The walking speed was estimated using the 10 m walking test. Musculoskeletal ultrasonography was performed to measure the thicknesses of three abdominal muscles of the paralytic side, i.e. transverse abdominis, internal oblique and external oblique muscles.
After treatment, the BBS scores of the two groups were significantly higher than those before treatment, with significant differences (P<0.05). The BBS score of the observation group was significantly higher than that of the control group (P<0.05). After treatment, the Brunnstrom stage and FMA scale score, and standing and stepping scores were significantly higher than those before treatment (P<0.05). The Brunnstrom stage, FMA scale score, stepping score and walking speed of the observation group significantly exceeded those of the control group (P<0.05). After treatment, the thicknesses all increased compared with those before treatment, but the thicknesses of internal oblique and external oblique muscles were not significantly different (P>0.05). The thickness of transverse abdominis muscle of the observation group significantly surpassed that before treatment (P<0.05), whereas the thicknesses of the control group were similar (P>0.05). The thickness of transverse abdominis muscle of the observation group was significantly higher than that of the control group (P<0.05).
Rehabilitation training of core muscle stability can effectively improve the balance function and walking speed of stroke patients, probably by increasing the thickness of transverse abdominis muscle.
评估核心肌肉稳定性康复训练对脑卒中偏瘫患者的影响。
选取2017年12月至2018年12月住院的180例脑卒中患者。将他们随机分为观察组和对照组（n = 90），两组均接受常规偏瘫康复治疗。在此基础上，观察组进行核心肌肉稳定性训练，每周5次，共8周。训练前后的平衡功能采用伯格平衡量表（BBS）进行评估。偏瘫下肢功能采用Brunnstrom分期和Fugl-Meyer运动评估（FMA）量表进行评价。步行速度采用10米步行试验进行估算。进行肌肉骨骼超声检查，测量瘫痪侧三块腹部肌肉即腹横肌、腹内斜肌和腹外斜肌的厚度。
治疗后，两组的BBS评分均显著高于治疗前，差异有统计学意义（P < 0.05）。观察组的BBS评分显著高于对照组（P < 0.05）。治疗后，Brunnstrom分期、FMA量表评分、站立和迈步评分均显著高于治疗前（P < 0.05）。观察组的Brunnstrom分期、FMA量表评分、迈步评分和步行速度均显著超过对照组（P < 0.05）。治疗后，所有肌肉厚度均较治疗前增加，但腹内斜肌和腹外斜肌厚度差异无统计学意义（P > 0.05）。观察组腹横肌厚度显著超过治疗前（P < 0.05），而对照组厚度相似（P > 0.05）。观察组腹横肌厚度显著高于对照组（P < 0.05）。
核心肌肉稳定性康复训练可有效提高脑卒中患者的平衡功能和步行速度，可能是通过增加腹横肌厚度实现的。
