摘要
目的:观察视觉提示激光手杖在偏瘫患者步行训练中的临床运用效果,探索一种新型视觉提示设备对于偏瘫患者步行能力恢复的影响。方法:将36例符合纳入标准的亚急性期偏瘫患者按照随机数字表法分为观察组和对照组,每组各18例,均进行为期3周的步行训练,每周5 d,每天1次,每次30 min。其中观察组在训练中使用带有激光视觉提示作用的手杖,手杖顶部的激光发射器发射2条平行射线并投射在地面上,这2条射线地面间距为20 cm,第一阶段嘱患者患侧先行迈步并使患侧足尖尽可能靠近后方红线,健侧足尖落在平行红线内;第二阶段嘱患者将患侧足尖落在平行红线内,健侧足尖超过前方红线;最后嘱患者将患侧步长逐步增加至与健侧相近。对照组使用普通手杖及适当的口头提示,训练前后2组进行步行功能评估,包括10 m步行测试、6 min步行试验、Berg平衡功能评分(BBS)及功能性步行能力分级(FAC)。观察比较2组评估结果。结果:经3周训练后2组患者步行功能较训练前均有提升,10 m步行测试、6 min步行试验及BBS评分均有明显改善,差异均有统计学意义(P<0.05)。训练后观察组10 m步行测试、6 min步行试验、BBS评分优于对照组,差异均有统计学意义(P<0.05),但训练后2组FAC分级比较,差异无统计学意义(P>0.05)。结论:在亚急性期脑卒中偏瘫患者步行训练中使用带有视觉提示作用的激光手杖较常规训练更有助于提升患者短距离步行速度、长距离步行效率,以及平衡功能表现,该方法简便易行,值得临床推广。
Objective:To observe the clinical application of laser cane in walking training of hemiplegic patients,and to explore the effect of a new visual cue device on the recovery of walking ability of hemiplegic patients.Methods:A total of 36 patients with subacute hemiplegia who met the inclusion criteria were randomly divided into observation group and control group,with 18 cases in each group.Both groups received walking training once a day for 3 weeks,30 min each time.The observation group was trained with a laser cane,a laser emitter on the top of the stick fired two parallel rays and projected them onto the ground at a distance of 20 cm.Methods were as followed:at first,the patients were told to step forward with affected foot and make the toes as close to the rear red line as possible,and the toes of the healthy side were between the two parallel red lines;secondly,the patients were told to put the affected toes between the parallel red lines,and the healthy toes exceeded the front red line;finally,the patients were instructed to gradually increase the stride length of the affected side to similar to that of the healthy side.The control group used an ordinary cane and received appropriate verbal cues.The walking functions of two groups were evaluated before and after training,including 10 m walk test,6-minute walk test,Berg balance scale(BBS)and functional ambulation category(FAC),and the evaluation results were compared.Results:After 3 weeks of training,the walking functions of patients in both groups were improved.10 m walk test,6-minute walk test and BBS scores were significantly improved,and the differences before and after training were compared and analyzed with statistical significance(P<0.05).After training,10 m walk test,6-minute walk test and BBS scores in the observation group were significant higher(P<0.05)than those in the control group.After training,there was no statistically significant difference in the FAC between the two groups(P>0.05).Conclusion:In the walking training of hemiplegic patients in subacute stage,walking stick with laser visual cue is helpful to improve the short distance walking speed,long distance walking efficiency,and balance function of patients.This method is simple and feasible,and worthy of clinical promotion.
作者
熊明月
赵亚雯
盘喆
唐美
郑诚
罗奕
谭洁
XIONG Mingyue;ZHAO Yawen;PAN Zhe;TANG Mei;ZHENG Cheng;LUO Yi;TAN Jie(The Central Hospital of Yongzhou,Yongzhou,Hunan 425000,China;College of Acupuncture-moxibustion and Massage,Hunan University of Chinese Medicine,Changsha,Hunan 410208,China)
出处
《康复学报》
CSCD
2021年第5期420-424,共5页
Rehabilitation Medicine
基金
湖南省残疾人康复科研项目(2019XK008)。
作者简介
通信作者:谭洁,E-mail:86869454@qq.com。
