基于Bobath理念的强化膝关节控制训练在痉挛性偏瘫患者康复中的应用

doi:10.3969/j.issn.2095-9400.2017.01.005

科研成果详情

题名	基于Bobath理念的强化膝关节控制训练在痉挛性偏瘫患者康复中的应用
其他题名	Application of the knee joint control training based on Bobath concept framework in rehabilitation of spastic hemiplegia patients
作者	樊留博 1; 江毅卿 1; 刘宝华2; 韩文胜 1; 刘素芝 1; 王玲玲 1; 卢战 1
发表日期	2017-01-25
发表期刊	温州医科大学学报影响因子和分区
语种	中文
原始文献类型	学术期刊
关键词	膝关节控制训练 Bobath理念表面肌电图剪切波超声弹性成像卒中
其他关键词	knee joint control training ; Bobath concept ; surface electromyography ; shear-wave ultrasound elasticity imaging ; stroke
摘要	目的:在Bobath理念指导下改进膝关节控制训练方法,应用表面肌电及超声弹性成像技术评估膝关节控制训练对脑卒中后偏瘫痉挛下肢膝关节控制能力恢复的影响。方法:选取2013年7月至2014年12月在温州医科大学附属台州医院住院的脑卒中偏瘫后下肢痉挛患者46例,随机分为治疗组和对照组,每组23例。对照组采用常规康复治疗方法,治疗组在常规康复治疗方法基础上应用Bobath理念指导进行膝关节控制强化训练。2组患者分别于治疗前与治疗6周后采用改良Ashworth评分(MAS)、临床痉挛指数(CSI)、下肢简化Fugl-Meyer运动量表(FMA-LE)评定及表面电极引导和记录肌电信号并进行线性时、频分析,同时应用实时定量剪切波超声弹性成像技术获取2组患者患侧股外侧肌、股内侧肌、股直肌及股二头肌长轴杨氏模量值,并进行对比分析。结果:2组治疗前MAS、CSI、FMA-LE评分比较差异无统计学意义(P<0.05);治疗6周后2组患者MAS和CSI评分均较治疗前下降(P<0.05),而下肢FMA-LE评分较治疗前明显提高(P<0.05),治疗组与对照组比较差异有统计学意义(P<0.05);2组治疗前中位频率(MF)、平均功率频率(MPF)协同收缩率均无明显差异,经治疗后膝关节拮抗肌群平均肌电值(AEMG)协同收缩率明显降低,差异有统计学意义(P<0.05)。与对照组比较,治疗组膝关节拮抗肌群AEMG协同收缩率降低优于对照组(P<0.01);2组患者治疗后患侧股外侧肌、股内侧肌、股直肌及股二头肌杨氏模量值比治疗前下降(均P<0.05),治疗组与对照组比较下降更明显(P<0.05)。结论:采用基于Bobath理念的膝关节运动控制训练能够缓解脑卒中后偏瘫侧痉挛下肢的肌张力,明显提高脑卒中患者步行功能,从而提高患者的生活质量。
其他摘要	Objective: To observe the effects of the knee joint control training based on Bobath concept framework intervening on motor control of spastic hemiplegia patients by analyzing the sEMG signals.Meth-ods:Forty-six patients with spastic hemiplegia from July 2013 to December 2014 in Taizhou Hospital Afifliated to Wenzhou Medical University were randomly divided into two groups. There were 23 patients in observa-tion group which were treated by the traditional rehabilitation training and control training of knee joint, and 23 patients in control group which were treated only by the traditional rehabilitation therapy training. Modiifed Ashworth scale (MAS), clinic spasticity index (CSI) and Fugl-Meyer assessment of lower extremity (FMA-LE) were used as outcome measure pre-training and post-training after 6 weeks by two appointed raters. The electromyography signals were collected by surface electrode and then processed by linear time-and frequency-domain method. Real-time shear wave ultrasound elasticity imaging of vastus lateralis, vastus medialis, rectus femoris and biceps femoris in longitudinal section was performed in therapy group and control group, then the results were compared and analyzed.Results:After treatment for 6 week. Lower FAM-LE scores in both groups were signiifcantly increased, and the lower extremity MAS and CSI in both groups were decreased signiifcantly as compared with those before treatment (P<0.05). More observation in observation group (P<0.05). Longitudi-nal Young’s modulus values of the vastus lateralis, vastus medialis, rectus femoris and biceps femoris of therapy group were lower than those of control group (P<0.01). Cocontraction ratio were decreased before treatment dur-ing knee maximum isometric voluntary contraction (P<0.05), and observation group were more apparently than control group (P<0.05).Conclusion: The knee joint control training based on Bobath concept framework can relieve the muscle tonus, effectively improve stroke patients lower limb function ,and improve the quality of life of spastic hemiplegia patients.
资助项目	浙江省医药卫生科技计划项目（2014KYA224,2012KYB238,2010KYB124）;台州市科技计划项目（14SF03）;浙江省中医药科技计划项目（2011ZB158）
ISSN	2095-9400
卷号	47 期号:01 页码:23-28
DOI	10.3969/j.issn.2095-9400.2017.01.005
页数	6
收录类别	CNKI ; 万方 ; 维普 ; ISTIC
URL	查看原文
社科自定义期刊分类	G类
CNKI分类号	R743.3 ; R493
引用统计
文献类型	期刊论文
条目标识符	https://kms.wmu.edu.cn/handle/3ETUA0LF/40812
专题	第二临床医学院，附属第二医院、育英儿童医院_康复医学
作者单位	1.温州医科大学附属台州医院康复医学科; 2.温州医科大学附属第二医院康复医学科
推荐引用方式 GB/T 7714	樊留博,江毅卿,刘宝华,等. 基于Bobath理念的强化膝关节控制训练在痉挛性偏瘫患者康复中的应用[J]. 温州医科大学学报,2017,47(01):23-28.
APA	樊留博., 江毅卿., 刘宝华., 韩文胜., 刘素芝., ... & 卢战. (2017). 基于Bobath理念的强化膝关节控制训练在痉挛性偏瘫患者康复中的应用. 温州医科大学学报, 47(01), 23-28.
MLA	樊留博,et al."基于Bobath理念的强化膝关节控制训练在痉挛性偏瘫患者康复中的应用".温州医科大学学报 47.01(2017):23-28.

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