您的位置:山东大学 -> 科技期刊社 -> 《山东大学学报(医学版)》

山东大学学报 (医学版) ›› 2021, Vol. 59 ›› Issue (3): 86-91.doi: 10.6040/j.issn.1671-7554.0.2020.1611

• 临床医学 • 上一篇    下一篇

渐进性核心稳定性训练在30例卒中患者的应用

戴勇1,殷欣慰1,黄怀2,邢然然2,李新亚2,钱绮雯2,叶云霞2   

  1. 1. 广州中医药大学, 广东 广州 510405;2.中国人民解放军南部战区总医院高压氧康复科, 广东 广州 500010
  • 发布日期:2021-04-06
  • 通讯作者: 黄怀. E-mail:huanghuai1999@163.com
  • 基金资助:
    军队后勤科研计划(CWH17J022);2020军队后勤科研项目(CLB20J034)

Application of progressive core stability training in 30 stroke patients

DAI Yong1, YIN Xinwei1, HUANG Huai2, Xin Ranran2, LI Xinya2, QIAN Qiwen2, YE Yunxia2   

  1. 1. Guangzhou University of Chinese Medicine, Guangzhoug 510405, Guangdong, China;
    2. Department of Hyperbaric Oxygen&
    Rehabilitation, General Hospital of Southern Theatre Command, Guangzhou 510010, Guangdong, China
  • Published:2021-04-06

摘要: 目的 探讨渐进性核心稳定性训练(PCST)对卒中患者肺康复的影响。 方法 回顾性分析60例卒中患者的临床资料,按干预措施分为常规核心稳定性训练(CST)组和PCST组。通过便携式呼吸功能检查仪和数字压力计评估呼吸功能;应用Berg平衡量表、躯干障碍量表和改良Barthel指数评估躯干功能和生活质量;记录摔倒、扭伤或压疮等不良事件。 结果 治疗前两组患者一般资料、呼吸功能指标、BBS评分、躯干功能障碍量表(TIS)评分和MBI评分基线值差异无统计学意义(P>0.05);治疗6周后,患者呼吸功能、BBS、TIS和MBI评分均较治疗前明显改善(P<0.05);治疗后PCST组患者最大吸气压(MIP)[(68.04±8.11)cmH2O]、呼吸峰流速(PEF)[(7.48±0.44)L/min]、BBS[(45.44±5.65)分]、TIS[(16.81±2.48)]和MBI[(70.04±5.72)]评分均优于CST组(62.46±8.41)cmH2O、(6.91±0.20)L/min、(38.69±5.12)、(15.35±2.07)、(62.00±8.18),差异有统计学意义(P<0.05);训练过程中两组患者均无摔倒、扭伤、疾病复发及压疮等。 结论 PCST能有效改善患者呼吸功能、运动功能和生活质量,在促进患者肺康复中更具优势,值得临床进一步推广应用。

关键词: 渐进性核心稳定性训练, 卒中, 肺康复, 呼吸功能, 运动功能

Abstract: Objective To explore the effects of progressive core stability training(PCST)on the pulmonary rehabilitation of stroke patients. Methods The clinical data of 60 stroke patients were retrospectively analyzed. The patients were divided into the core stability training group(CST group, n=30)and PCST group(n=30). Pulmonary function data were assessed with portable lung function tester; trunk function and quality of life were assessed with Berg Balance Scale, Trunk Disorder Scale and Modified Barthel Index; incidences of adverse events such as falls, sprains and pressure sores were recorded. Results There were no significant differences in the general data, respiratory function index, BBS, TIS and MBI scores between the two groups before treatment(P>0.05). After 6 weeks of treatment, the key respiratory function index, BBS, TIS and MBI scores improved significantly in both groups(P<0.05). Intergroup comparison showed the PCST group had more significant improvement than the CST group in MIP [(68.04±8.11)vs(62.46±8.41)cmH2O], PEF [(7.48±0.44)vs(6.91±0.20)L/min], BBS [(45.44±5.65)vs(38.69±5.12)], TIS [(16.81±2.48)vs(15.35±2.07)] and MBI [(70.04±5.72)vs(62.00±8.18)](P<0.05). There were no adverse events during training in either groups. Conclusion Able to improve patients respiratory function, motor function and quality of life, PCST is more effective in promoting pulmonary rehabilitation of stroke patients, and is worth popularizing in clinical practice.

Key words: Progressive core stability training, Stroke, Pulmonary rehabilitation, Lung function, Motor function

中图分类号: 

  • R493
[1] Feigin VL, Nguyen G, Cercy K, et al. Global, regional, and country-specific lifetime risks of stroke,1990 and 2016 [J]. N Engl J Med, 2018, 379(25): 2429-2437.
[2] 中国脑卒中防治报告编写组.《中国脑卒中防治报告》概要[J]. 中国脑血管病杂志, 2020, 17(5): 272-281.
[3] Lyons OD, Ryan CM. Sleep apnea and stroke [J]. Can J Cardiol, 2015, 31(7): 918-927.
[4] Duncan F, Kutlubaev MA, Dennis MS, et al. Fatigue after stroke: a systematic review of associations with impaired physical fitness [J]. Int J Stroke, 2012, 7(2): 157-162.
[5] Report on stroke prevention and treatment in china writing group. Brief report on stroke prevention and treatment in china, 2019 [J]. Chin J Cerebrovasc Dis, 2020, 17(5): 272-281.
[6] 王晨, 王人卫, 杨坚, 等. 核心稳定性训练结合常规康复治疗对脑卒中患者躯干肌肉厚度, 活动度的分析[J]. 中国康复医学杂志, 2019, 34(9): 1065-1070.
[7] HE Nashar, AE Wishy, H Helmy, et al. Do core stability exercises improve upper limb function in chronic stroke patients [J]. J Neurol Neurosurg Psychiatry, 2019, 55(49): 1-9.
[8] Lee K, Park D, Lee G. Progressive respiratory muscle training for improving trunk stability in chronic stroke survivors: a pilot randomized controlled trial [J]. J Stroke Cerebrovasc Dis. 2019, 28(5): 1200-1211.
[9] 王新德. 各类脑血管疾病诊断要点[J]. 中华神经科杂志, 1996, 29(6): 379-380.
[10] 国家卫生健康委员会, 国家中医药管理局. 新型冠状病毒肺炎诊疗方案试行第八版[J].中国医药, 2020, 15(10): 1494-1499. General Office of National Health Commission of the Peoples Republic of China,Office of National Administration of Traditional Chinese Medicine.Diagnosis and treatment of corona virus disease-19(8th trial edition)[J]. China Medicine, 2020, 15(10): 1494-1499.
[11] 戴勇, 黄怀. 呼吸肌训练在脑卒中患者肺康复中的应用进展[J]. 中华脑科疾病与康复杂志电子版, 2020, 10(1): 48-52. DAI Yong, HUANG Huai. Application and progress of respiratory muscle training in stroke patients with pulmonary rehabilitation [J]. Chin J Brain Dis Rehabil(Electronic Edition), 2020,10(1): 48-52.
[12] Naghavi FS, Koffman EE, Lin B, et al. Post-stroke neuronal circuits and mental illnesses [J]. Int J Physiol Pathophysiol Pharmacol, 2019,11(1): 1-11.
[13] Spruit MA, Singh SJ, Garvey C, et al. An official American Thoracic Society/European Respiratory Society statement: key concepts and advances in pulmonary rehabilitation [J]. Am J Respir Crit Care Med, 2013, 188(8): 13-64.
[14] Alqahtani AS, Alajam R, Eickmeyer SM, et al. Feasibility and trend of pulmonary function in a pilot trial of aerobic walking exercise in non-ambulatory stroke survivors [J]. Top Stroke Rehabil, 2020, 27(3): 190-198.
[15] Haruyama K, Kawakami M, Otsuka T. Effect of core stability training on trunk function, standing balance, and mobility in stroke patients [J]. Neurorehabil Neural Repair, 2017, 31(3): 240-249.
[16] Bergmark A. Stability of the lumbar spine. A study in mechanical engineering [J]. Acta Orthop Scand Suppl, 1988, 60(2): 1-54.
[17] Panjabi M.The stabilizing system of the spine part I. function, dysfunction, adaptation, and enhancement [J]. J Spinal Disord, 1992, 5(4): 383-389.
[18] Hodges PW, Richardson CA. Contraction of the abdominal muscles associated with movement of the lower limb [J]. Phys Ther, 1997, 77(2): 132-144.
[19] Kibler WB, Press J, Sciascia A. The role of core stability in athletic function [J]. Sports Med, 2006, 36(3): 189-198.
[20] 刘永芳, 齐林, 张晓菁, 等. 高压氧联合核心稳定性训练治疗恢复期脑卒中患者的疗效观察[J]. 中华物理医学与康复杂志, 2020, 42(2): 143-145. LIU Yongfang, QI Lin, ZHANG Xiaojing, et al. Observation on the effect of hyperbaric oxygen combined with core stability training in the treatment of patients with stroke in recovery period [J]. Chinese Journal of Physical Medicine and Rehabilitation, 2020, 42(2): 143-145.
[21] Van Criekinge T, Truijen S, Schroder J, et al. The effectiveness of trunk training on trunk control, sitting and standing balance and mobility post-stroke: a systematic review and meta-analysis [J]. Clin Rehabil, 2019, 33(6): 992-1002.
[22] 刘婷婷, 雷梦杰, 金昌德. 核心稳定性训练对脑卒中患者康复效果的系统评价及试验序贯分析[J]. 临床与病理杂志, 2019, 39(1): 110-119. LIU Tingting, LEI Mengjie, JIN Changde. Effectiveness of core stability exercise for rehabilitation of stroke patients with hemiplegia: a systematic review with trial sequential analysis [J]. Journal of Clinical and Pathological Research, 2019, 39(1): 110-119.
[23] Bae SH, Lee HG, Kim YE, et al. Effects of trunk stabilization exercises on different support surfaces on the crosssectional area of the trunk muscles and balance ability [J]. J Phys Ther Sci, 2013, 25(6): 741-745.
[24] De Luca A, Squeri V, Barone LM, et al. Dynamic stability and trunk control improvements following robotic balance and core stability training in chronic stroke survivors: a pilot study [J]. Front Neurol, 2020, 17(11): 494.
[25] Cohen E, Mier A, Heywood P, et al. Diaphragmatic movement in hemiplegic patients measured by ultrasonography [J]. Thorax, 1994, 49(9): 890-895.
[26] Yoon HS, Cha YJ, You JSH. Effects of dynamic core-postural chain stabilization on diaphragm movement, abdominal muscle thickness, and postural control in patients with subacute stroke: A randomized control trial [J]. Neuro Rehabilitation, 2020, 46(3): 381-389.
[27] Son MS, Jung DH, You JH, et al. Effects of dynamic neuromuscular stabilization on diaphragm movement, postural control, balance and gait performance in cerebral palsy [J]. Neuro rehabil, 2017, 41(4): 739-746.
[28] Yoon HS, Cha YJ, You JSH. The effects of dynamic core-postural chain stabilization on respiratory function, fatigue and activities of daily living in subacute stroke patients: A randomized control trial [J]. Neuro Rehabilitation, 2020, 47(4): 471-477.
[1] 房启迪,杨淑霞,齐畅,程传龙,韩闯,刘盈,崔峰,李秀君. 基于镇街尺度的淄博市2019年脑卒中时空分布[J]. 山东大学学报 (医学版), 2022, 60(2): 81-88.
[2] 赵璇,李晓鹏,李剑,田彬,王广君. 磁珠耳穴贴压联合重复经颅磁刺激对脑卒中后抑郁的疗效[J]. 山东大学学报 (医学版), 2022, 60(1): 65-70.
[3] 陈希,刘新宇,范立霞,田永昊,原所茂. 老年脊柱疾病应用颈动脉超声评估缺血性脑卒中风险的临床价值[J]. 山东大学学报 (医学版), 2019, 57(5): 48-55.
[4] 郝小蕊,赵昌盛. 肠内和肠外营养支持对早期重症脑卒中患者血清ALT、SCr浓度变化及并发症的影响[J]. 山东大学学报 (医学版), 2019, 57(3): 80-84.
[5] 杨夏鑫,孟明珠,纪坤乾,王晓棠,童丽丽,王爱芹,赵秀鹤. 线粒体脑肌病伴高乳酸血症和卒中样发作中癫痫发作的临床特征[J]. 山东大学学报 (医学版), 2018, 56(5): 74-80.
[6] 王纪传,刘瑞红,李东芝,薛付忠. 地理加权回归在脑卒中病因探索中的应用[J]. 山东大学学报(医学版), 2017, 55(8): 88-94.
[7] 李敏,王春霞,夏冰,朱茜,孙苑潆,王淑康,薛付忠,贾红英. 健康管理人群脑卒中风险预测模型[J]. 山东大学学报(医学版), 2017, 55(6): 93-97.
[8] 曲立新,时兴华,杜怡峰. 急性缺血性脑卒中患者血浆PMP及EMP含量与预后的相关性[J]. 山东大学学报(医学版), 2016, 54(12): 32-36.
[9] 陈海丽, 顾娇阳, 张文静, 袁琳冉, 郑娟, 袁中瑞. 经典Wnt信号通路在大鼠脑缺血后血管新生中的作用[J]. 山东大学学报(医学版), 2015, 53(4): 31-36.
[10] 郑娟, 李政, 张文静, 袁琳冉, 樊书菠, 刘玉刚, 袁中瑞. Caveolin-1对脑缺血大鼠血管新生的影响[J]. 山东大学学报(医学版), 2015, 53(10): 16-20.
[11] 霍兴兰. 无创呼吸机治疗呼吸衰竭84例的临床观察[J]. 山东大学学报(医学版), 2014, 52(S2): 50-50.
[12] 刘结梅, 黄国志, 刘健, 蔡奇芳. 早期康复治疗对脑卒中后肩手综合征及 上肢运动功能的影响[J]. 山东大学学报(医学版), 2014, 52(S2): 59-60.
[13] 赵华1,徐洋洋2,鹿向东3,徐同江1 . Ki-67、PTTG、VEGF与垂体瘤卒中的相关性[J]. 山东大学学报(医学版), 2014, 52(5): 82-85.
[14] 吴倩1,丁启翠2,宋国栋1,王伟1. 老年慢性卒中后肺炎的临床特征及预后因素[J]. 山东大学学报(医学版), 2013, 51(5): 75-79.
[15] 蔡毅,龙发青,曾超胜,苏庆杰,吴海荣,吴映曼,李鹏翔,周经霞,王德生,张余辉. 缺血性脑卒中二级预防中高血压防治的现状及其影响因素[J]. 山东大学学报(医学版), 2013, 51(3): 76-79.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
[1] 史爽,李娟,米琦,王允山,杜鲁涛,王传新. 胃癌miRNAs预后风险评分模型的构建与应用[J]. 山东大学学报 (医学版), 2020, 1(7): 47 -52 .
[2] 吕龙飞,李林,李树海,亓磊,鲁铭,程传乐,田辉. 腔镜下细针导管空肠造瘘在微创McKeown食管癌切除术中的应用[J]. 山东大学学报 (医学版), 2020, 1(7): 77 -81 .
[3] 邵海港, 王璇, 王青. 山东地区人下颌第一前磨牙根管系统解剖研究[J]. 山东大学学报(医学版), 2014, 52(9): 85 -89 .
[4] 黄飞,王怀经,邢毅,高薇,李永刚,邢子英,李振中. NGF和GM1联合应用对坐骨神经损伤大鼠初级传入神经元的保护作用[J]. 山东大学学报(医学版), 2006, 44(4): 332 -335 .
[5] 姜保东,马祥兴,王青,王茜,冯晓源,李克,于富华 . 脑CT静脉造影扫描时相及重建层厚的选择[J]. 山东大学学报(医学版), 2008, 46(11): 1084 -1086 .
[6] 唐芳1,2 ,张颖倩3 ,王志强4 ,康殿民4 ,王洁贞1 ,薛付忠1 . 自然疫源性疾病疫源地空间结构的二维
最小生成树模型及其应用
[J]. 山东大学学报(医学版), 2009, 47(01): 106 -110 .
[7] 李玉亮,王永正,王晓华,张福君,朱立东,张万明,李 征,李振家,张开贤 . 动脉灌注吉西他滨联合125I粒子胰腺内植入治疗进展期胰腺癌[J]. 山东大学学报(医学版), 2007, 45(4): 393 -396 .
[8] 朱晓丽1,郭淑玲1,苏磊1,冯玉新2,袁方曙1. 蠕形螨全蛋白提取及相对分子量鉴定[J]. 山东大学学报(医学版), 2014, 52(5): 58 -62 .
[9] 李洧,李道卫,叶茜,高顺翠,姜淑娟. 经支气管镜针吸活检在纵隔疾病诊断中的价值[J]. 山东大学学报(医学版), 2008, 46(11): 1063 -1065 .
[10] 王旭平,赵玲,冯玉新,商林珊,刘金成,曹伟朋,朱晓音,辛华. 绞股蓝总苷对谷氨酸诱导的胎鼠大脑皮层神经元氧化性损伤保护机制的研究[J]. 山东大学学报(医学版), 2006, 44(6): 564 -567 .