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躯干练习联合髋关节策略训练对提高脑卒中患者独立水平和平衡能力的效果:随机对照研究。

The effect of trunk exercises with hip strategy training to maximize independence level and balance for patient with stroke: Randomized controlled study.

机构信息

Department of Physical Therapy and Rehabilitation, King Khalid Hospital, Second Health Cluster, Ministry of Health, Majmaah, Saudi Arabia.

Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Al Majmaah University, Al Majmaah, Saudi Arabia.

出版信息

Physiother Res Int. 2024 Oct;29(4):e2142. doi: 10.1002/pri.2142.

Abstract

BACKGROUND

Balance while seated and the capacity to conduct selective trunk movements are significant predictors of functional outcomes following stroke. Patients with inappropriate muscle activation and inadequate movement control in the trunk muscles cause mobility and daily function difficulties. Stroke patients have weak leg muscles and decreased balance, resulting in compensatory changes. Functional postural strategy training is necessary to restore balance in these patients. Few studies have examined the effect of physical therapy trunk exercises with hip strategy training on improving balance and increasing independence after stroke.

PURPOSE

This study aimed to explore the effect of selective trunk exercises (STE) with hip strategy training in improving balance in patients with stroke as well as independence levels.

METHOD

A multicenter inpatient stroke treatment randomized pre- and post-test control trial. Forty-six stroke survivors were randomly allocated to experimental or control groups (n = 23 each). The experimental group received hip strategy training and trunk exercises. All groups received Neuro-Developmental Treatment (NDT)-based physical therapy four times a week for 6 weeks. Trunk impairment scale, Berg Balance Scale (BBS), and functional independence measure (FIM) measured static and dynamic seated balance, functional balance, and trunk movement coordination pre- and post-therapy.

RESULTS

The experimental group's post-therapeutic measures were substantially higher than the control group. The experimental group's TIS score, and subscale improved more than the control group. The experimental group considerably increased the BBS score. The experimental group also showed greater FIM gains.

CONCLUSIONS

This study demonstrated that adding STE in conjunction with hip strategy training to patients after has a positive impact on trunk control while maintaining static and dynamic sitting balance, functional balance, and independence levels which are effective in stroke rehabilitation.

摘要

背景

坐位平衡和选择性躯干运动能力是脑卒中后功能预后的重要预测指标。躯干肌肉肌肉激活不当和运动控制不足的患者会导致活动和日常功能困难。脑卒中患者腿部肌肉无力,平衡能力下降,导致代偿性变化。有必要对这些患者进行功能性姿势策略训练以恢复平衡。很少有研究探讨过带髋关节策略训练的躯干物理治疗对改善脑卒中后平衡和提高独立性的影响。

目的

本研究旨在探讨选择性躯干运动(STE)结合髋关节策略训练对改善脑卒中患者平衡和提高独立性的作用。

方法

多中心住院脑卒中治疗随机前后测试对照试验。46 名脑卒中幸存者被随机分配到实验组和对照组(n=23)。实验组接受髋关节策略训练和躯干运动。所有组均每周接受 4 次基于神经发育治疗(NDT)的物理治疗,持续 6 周。躯干障碍量表、伯格平衡量表(BBS)和功能独立性测量(FIM)分别在治疗前后测量静态和动态坐位平衡、功能性平衡和躯干运动协调性。

结果

实验组治疗后的测量值明显高于对照组。实验组的 TIS 评分和子量表的改善程度大于对照组。实验组 BBS 评分显著增加。实验组 FIM 也有更大的收益。

结论

本研究表明,在脑卒中患者中增加 STE 联合髋关节策略训练对维持静态和动态坐位平衡、功能性平衡和独立性水平的躯干控制有积极影响,在脑卒中康复中是有效的。

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