周苗苗 赵凯 徐梅 杨梅 王娟

【摘要】 目的：观察自我节律性引导对脑卒中偏瘫患者步行功能的即刻影响。方法：选取2023年2—8月就诊于安徽医科大学第一附属医院康复医学科，并符合本次研究入组标准的20例脑卒中肢体偏瘫患者，在节律引导前及自我节律性引导步行过程中，均使用意大利BTS公司的P-WALK平板压力测试系统进行数据采集。采集的参数指标包括：步速、步幅、步态周期、患侧预承重期、患侧单支撑期、患侧预摆动期、患侧摆动期。结果：与节律引导前步行比较，20例测试患者自我节律性引导步行患者步速、患侧步幅、健侧步幅均明显提高（P<0.05），患侧步态周期及健侧步态周期均明显缩短（P<0.05）。患侧预承重期和预摆动期占患侧步态周期比例均显著减小，患侧单支撑期和摆动期占患侧步态周期的比例均明显提高（P<0.05）。结论：脑卒中偏瘫患者行自我节律性引导步行时，可以一定程度提高步速和步幅，同时偏瘫肢体的预承重期、预摆动期、单支撑期和摆动期占患侧步态周期比例均不同程度趋于正常。因此，脑卒中偏瘫患者在下肢步行康复训练过程中行自我节律性引导，可以改善步行功能及纠正偏瘫患者异常步态。

【关键词】 脑卒中 偏瘫 自我节律性引导 步行功能

The Immediate Effect of Self Rhythmic Guidance on Walking Function in Stroke Patients with Hemiplegia/ZHOU Miaomiao， ZHAO Kai， XU Mei， YANG Mei， WANG Juan. //Medical Innovation of China， 2024， 21（15）： 0-096

[Abstract] Objective： To observe the immediate effect of self rhythmic guidance on walking function in stroke hemiplegic patients. Method： A total of twenty stroke patients with hemiplegia who visited the Rehabilitation Medicine Department of the First Affiliated Hospital of Anhui Medical University from February to August 2023 and met the inclusion criteria for this study were selected， before rhythm guidance and during self rhythm guided walking， data was collected using the P-WALK tablet pressure testing system from BTS， Italy. The collected parameter indicators included gait speed， stride， gait cycle， pre load bearing period on the affected side， single support period on the affected side， pre swing period on the affected side， and swing period on the affected side. Result： Compared with pre rhythm guided walking， the pace， affected side stride and healthy side stride of 20 test patients were significantly improved （P<0.05）， and the gait cycle on the affected side and healthy side were significantly shortened （P<0.05）. The proportion of pre weight-bearing period and swing period to the affected side's gait cycle were significantly decreased， while the proportion of single support period and swing period to the affected side's gait cycle significantly increased （P<0.05）. Conclusion： When stroke patients with hemiplegia perform self rhythmic guided walking， they can improve their gait speed and stride to a certain extent. At the same time， the proportion of pre weight-bearing period and swing period， single support period， and swing period of the hemiplegic limb to the affected side's gait cycle tends to be normal to varying degrees. Therefore， self rhythmic guidance during lower limb walking rehabilitation training can improve walking function and correct abnormal gait in stroke patients with hemiplegia.

[Key words] Stroke Hemiplegia Self rhythmic guidance Walking function

First-author's address： Department of Rehabilitation， the First Affiliated Hospital of Anhui Medical University， Hefei 230000， China

doi：10.3969/j.issn.1674-4985.2024.15.022

现代康复理论和实践证明，有效的康复训练能够减轻脑卒中患者的残疾，提高下肢步行功能，但是脑卒中的恢复需要较长时间，专业机构康复治疗时间有限，以家庭为基础的干预措施显得尤为重要[1]。步行能力被认为是决定健康状况的重要标志和健康结果的预测指标[2]。近年来通过节律性视听觉刺激进行步态训练越来越多用于脑卒中步态康复领域[3-4]。本次研究利用平板压力测试系统检测患者步行的参数指标，比较节律引导前和自我节律性引导对偏瘫患者步行功能的影响，探讨自我节律性引导在偏瘫患者步行能力及异常步态中的作用，以期指导患者在家庭或社区进行持续步态训练。

1 资料与方法

1.1 一般资料

选取2023年2—8月安徽医科大学第一附属医院康复医学科门诊及住院的20例脑卒中偏瘫患者。……