摘要
目的:探讨运动疗法治疗胸段脊髓损伤患者的疗效。方法:于2001-07/2005-10选择深圳市第九人民医院康复科收治的胸段脊髓损伤患者15例为研究对象。采用运动疗法增强拮抗肌功能,抑制下肢痉挛状态,训练时先在该肢体做轻柔的按摩,待松弛后再做训练,尽量使关节活动达到较大范围。每达到一定范围时,持续牵拉10s。重症者进行轮椅训练,并为1例完全性脊髓损伤患者制作了髋膝踝足矫形器,在平行杠内进行站立支撑和行走训练。治疗50min/次,1次/d,30d为1个疗程。治疗前后评定ASIA运动分、肌痉挛程度、日常生活活动能力,并进行体感诱发电位测定。结果:①治疗后ASIA运动分和日常生活活动能力积分比治疗前显著升高,差异有显著性意义[ASIA运动分分别为(71.11±18.17),(60.21±19.22)分;改良巴氏指数分别为63.01±19.40,34.12±20.13,P<0.01]。②肌痉挛评定:治疗前肌张力增高者11例,其中1+级1例,2级2例,3级5例,4级3例;治疗后0级2例,1级3例,1+级2例,2级2例,3级2例。③体感诱发电位检查也有一定程度改善。结论:运动治疗对胸段脊髓损伤具有明显疗效,能够明显的改善患者双下肢的痉挛性瘫痪症状,促进肢体运动功能的恢复。
AIM： To investigate the therapeutic effect of exercise therapy on patients with thoracic spinal cord injury （SCI）.
METHODS： Fifteen patients with thoracic SCI between July 2001 and October 2005 were selected from the Department of Rehabilitation, Shenzben Ninth People＇s Hospital. Exercise therapy was used to strengthen the function of antagonistic muscle and restrain the muscle spasm of lower limbs. Light and soft massage was conducted on lower limbs in advance, and exercises was clone after relaxed. The joint motion should reach to a range as wider as possible, and drag was continuously performed for 10 seconds at each time of reaching. Patients with severe symptoms received wheelchalr-training, and the hip-knee-ankle-foot orthosis was exerted on one patient with complete SCI, who exercised to stand up and walk in parallel bars. Patients received the treatment once a clay for 50 minutes each time and 30 clays as one course. The ASIA motor scores, extent of muscle spasm and ability in activity of daily living （ADL） were evaluated before and after the treatment, and the somatosensory evoked potential （SEP） was examined.
RESULTS： （1）The ASIA motor score and score of ability in ADL were obviously enhanced after treatment than before treatment, and the differences were remarkable [score of ASIA motor was respectively （71.11±18.17 ） and （60.21±19.22）points, and the Modified Barthel Index was respectively 63.01±19.40, 34.12±20.13,P 〈 0.01].（2）Score of muscle spasm： there were 11 patients with hypermyotonia before treatment, in which one patient was grade 1＋, two patients were grade two, five were grade three and three were grade four, while after the treatment, two were grade zero, three were grade one, two were grade 1 ＋, two were grade two and two were grade three.（3）There was certain amelioration in examination of SEP. CONCLUSION： Exercise therapy has an obvious effect on thoracic SCI, which can significantly ameliorate the spastic paralytic symptoms of both lowec limbs and promote the recovery of motor function in extremity.
出处
《中国临床康复》
CAS
CSCD
北大核心
2006年第44期36-37,共2页
Chinese Journal of Clinical Rehabilitation
