作者：严会荣1 ，巴努 ? 巴克尔 2 ，许多红 1 ，卢艳丽 3

单位：

1.830054 新疆维吾尔自治区乌鲁木齐市，新疆医科大学第一附属医院康复医学科；2.830054 新疆维吾尔自治区乌鲁木齐市，新疆乌鲁木齐市中医医院骨科；3.010059 内蒙古自治区呼吸浩特市，内蒙古医科大学附属医院康复医学科；通信作者：卢艳丽，E-mail：34783838@qq.com

Units：

1.Department of Rehabilitation Medicine，the First Affiliated Hospital of Xinjiang Medical University，Urumqi 830054，China；2.Department of Orthopedics，Xinjiang Urumqi Traditional Chinese Medicine Hospital，Urumqi 830054，China；3.Department of Rehabilitation Medicine，Affiliated Hospital of Inner Mongolia Medical University，Hohhot 010059，China；Corresponding author：LU Yanli，E-mail：34783838@qq.com

关键词：

卒中；偏瘫；膝关节反张；悬吊运动疗法

Keywords：

Stroke；Hemiplegic；Genu recurvatum；Sling exercise therapy

CLC：

R 743　R 682.22

DOI：

DOI：10.3969/j.issn.1008-5971.2020.01.015

Funds：

新疆维吾尔自治区自然科学基金资助项目（2017D01C307）

摘要：

目的　探讨悬吊运动疗法（SET）在脑卒中偏瘫并膝关节反张患者中的应用效果。方法　选取 2016 年4 月—2019 年 3 月新疆医科大学第一附属医院收治的脑卒中偏瘫并膝关节反张患者 90 例，采用随机数字表法分为对照组和观察组，每组 45 例。对照组患者接受常规康复训练，观察组患者在对照组基础上采用 SET；两组患者均持续干预 4 周。比较两组患者干预前后膝过伸次数、Berg 平衡量表（BBS）评分、Fugl-Meyer 运动功能评定量表（FMA）下肢功能评分、10 m 步行时间，干预前及干预 2、4 周后患侧腓肠肌、股直肌、股二头肌积分肌电值（iEMG），干预后步行功能改善效果。结果　（1）两组患者干预前膝过伸次数、BBS 评分、FMA 下肢功能评分、10 m 步行时间比较，差异无统计学意义（P>0.05）；观察组患者干预后膝过伸次数少于对照组，BBS 评分、FMA 下肢功能评分高于对照组，10 m步行时间短于对照组（P<0.05）。（2）时间与方法在患侧腓肠肌、股直肌、股二头肌iEMG上存在交互作用（P<0.05）；时间、方法在患侧腓肠肌、股直肌、股二头肌 iEMG 上主效应均显著（P<0.05）。观察组患者干预 2、4 周后患侧腓肠肌、患侧股直肌、患侧股二头肌iEMG高于对照组（P<0.05）。（3）观察组患者干预后步行功能改善效果优于对照组（P<0.05）。结论　SET 可有效减轻脑卒中偏瘫并膝关节反张患者膝关节反张症状，改善患者肢体平衡能力、下肢运动功能及步行功能，增强患者下肢关键肌肉肌力。

Abstract：

Objective　To explore the application effect of sling exercise therapy（SET）in stroke-inducedhemiplegia patients complicated with genu recurvatum. Methods　From April 2016 to March 2019，a total of 90 stroke-hemiplegia patients complicated with genu recurvatum were selected in the First Affiliated Hospital of Xinjiang MedicalUniversity，and they were divided into control group and observation group according to random number table method，with45 cases in each group. Patients in control group received routine rehabilitation training，while patients in observation groupreceived SET based on that of control group；patients in the two groups were continuously intervened for 4 weeks. Number of kneeoverstretches，BBS score，FMA lower limb function score and elapsed time for 10-meter walking before and after intervention，iEMG of affected gastrocnemius muscle，rectus femoris and biceps femoris muscle before intervention，2 and 4 weeks afterintervention，as well as improvement effect of walking function after intervention were compared between the two groups.Results　（1）There was no statistically significant difference in number of knee overstretches，BBS score，FMA lower limbfunction score or elapsed time for 10-meter walking between the two groups before intervention（P>0.05）；number of kneeoverstretches in observation group was statistically significantly less than that in control group after intervention，BBS score andFMA lower limb function score in observation group were statistically significantly higher than those in control group，moreoverelapsed time for 10-meter walking in observation group was statistically significantly shorter than that in control group（P<0.05）.（2）There was statistically significant interaction between time and method in iEMG of affected gastrocnemius muscle，rectusfemoris and biceps femoris muscle（P<0.05）；main effects of time and method were statistically significant in iEMG of affectedgastrocnemius muscle，rectus femoris and biceps femoris muscle（P<0.05）.Compared with that in control group，iEMG ofaffected gastrocnemius muscle，rectus femoris and biceps femoris muscle in observation group was statistically significantlyhigher，respectively（P<0.05）.（3）Improvement effect of walking function in observation group was statistically significantlybetter than that in control group after intervention（P<0.05）. Conclusion　In stroke-induced hemiplegia patients complicatedwith genu recurvatum，SET can effectively relieve the symptoms of genu recurvatum，improve the limb balance ability，lowerlimb motor function and walking function，as well as enhance the key muscle strength of lower limbs.

ReferenceList：