脑卒中慢性期患者高强度重复步行训练的效果
陆敏杰 田 园 吴长伟 王裕行 王冬缘 侯亚静 王 泳
首都医科大学附属复兴医院，北京 100038
通信作者：王泳
【摘要】 目的 探讨高强度重复训练对卒中慢性期患者步行能力的有效性和安全性。方法 选取2020-09—2021-08 慢性期脑卒中患者 60 例为观察对象，对照组和治疗组各 30 例，治疗组接受以训练时靶心率和步数为目标的步行训练，每周 5 d，每天 2 h 康复训练，期间高强度重复性步行训练时间不少于1.5 h。对照组接受常规康复训练，每周 5 d，每天 2 d 康复训练。分别于训练前和训练后 2 周后采用功能性步行分级量表（FAC）、Berg 平衡量表（BBS）、10 m 最大速度步行测试（10MWT）、6 min 步行测试（6MWT）等指标评价治疗有效性。记录 2 组训练中发生的不良事件评价治疗的安全性。结果 治疗组中因陪护原因未坚持训练而脱落 1 例，其余均完成 2 周治疗。训练 2 周后，治疗组恢复独自步行能力（FAC≥4）21 例，明显高于对照组的 10 例（P<0.01）；治疗组 BBS 评分（44.52±10.31）分，明显高于对照组的（34.67±12.54）分（P<0.01）；治疗组 10MWT 为（0.69±0.31）m/s，明显高于对照组的（0.45±0.28）m/s（P<0.01）；治疗组 6MWT 为（192.14±89.96）m，明显高于对照组的（129.63±70.77）m（P<0.01）。治疗组患者治疗期间除出现 1 例臀部肌肉酸痛外，其余无不良反应。结论 高强度重复步行训练可以明显改善慢性期脑卒中患者的步行能力，且训练过程安全，无严重不良反应。
【关键词】 脑卒中；高强度训练；高重复训练；慢性期；步行训练
【中图分类号】 R743.3 【文献标识码】 A 【文章编号】 1673-5110 （2022） 04-0493-05
基金项目：北京市西城区优秀人才拔尖团队项目（编号：202155）
DOI：10.12083/SYSJ.212013
Effect of high intensity and high repetition walking training for chronic stroke patients
LU Minjie，TIAN Yuan，WU Changwei，WANG Yuxin，WANG Dongyuan，HOU Yajin，WANG Yong
Fuxing Hospital，Capital Medical University，Beijing 100038，China
Corresponding author: WANG Yong
【Abstract】 Objective To explore the availabity and security of high intensity and high repetition in walking ability of chronic stroke patients. Methods A total of 60 patients with chronic stroke from September 2020 to August 2021 were selected as the observation subjects and randomly divided into two groups，control group and treatment group each of 30 cases. The treatment group received walking training with the target heart rate and step number during training and 2 hours a day，5 days a week during that time the high intensity repetitive walking training not less than 1.5 hours. The control group was given routine rehabilitation training 2 hours a day，5 days a week. The functional walking scale （FAC），Berg balance scale （BBS），10 m maximum speed walking test （10MWT）and 6 min walking test（6MWT）were evaluated before and 2 weeks after training. Adverse effects during training were recorded to evaluated the safety of treatment group. Results In the treatment group，1 case were removed due to the accompanying reason and others completed 2 weeks treatment. After 2 weeks of training， 21 patients in the treatment group recovered their walking ability（FAC≥4），which was significantly higher than that in the control group（P<0.01）. The BBS score of the treatment group was（44.52±10.31）points，which was significantly higher than that of the control group（（34.67±12.54）points，P<0.01）. The 10MWT of the treatment group was（0.69±0.31）m/s，which was significantly higher than that of the control group（（0.45±0.28）m/s，P<0.01）. The 6MWT of the treatment group was（192.14±89.96）m，which was significantly higher than that of the control group （（129.63±70.77）m，P<0.01）. In the treatment group，there were no adverse reactions except 1 case of hip muscle soreness. Conclusion The high intensity and high repetition walking training can improve significantly the walking ability of patients with chronic stroke，and the training process is safe without serious adverse reactions.
【Key words】 Stroke；High intensity training；High repetition training；Chronic stage；Walking training
