川平法联合悬吊训练对脑卒中偏瘫患者下肢 运动功能及核心稳定性的效果评价

Evaluation of the Effect of Combined Sling Exercise Training with Kawahira Method on Lower Extremity Motor Function and Core Stability in Patients with Hemiplegia after Stroke

摘要: 目的：本研究旨在探讨常规康复训练基础上，联合川平法(RFE)与悬吊训练(SET)对脑卒中偏瘫患者下肢运动功能的改善效应，旨在优化临床干预策略，为患者的功能恢复提供循证医学依据。方法：选取本院住院期脑卒中患者60例，均符合Bruunstrom分期 ≥ III期、卒中后3周~6个月纳入标准。采用随机数字表法分为四组：常规康复组(A组)、RFE联合组(B组)、SET联合组(C组)及SET + RFE联合组(D组)。各组均接受为期4周的针对性干预。分别采用Fugl-Meyer下肢运动功能评分(FMA-LE)、步行功能分级(FAC)、Berg平衡量表(BBS)及Sheikh躯干控制评分进行评估。结果：组内对比显示，各组干预后各项指标较干预前均有显著改善(A组P < 0.05；B、C、D组P < 0.01)。组间分析显示，B组与C组的FMA-LE评分显著优于A组(P < 0.05)，而D组FMA-LE评分改善程度非常显著优于A组(P < 0.01)。在平衡功能方面，D组BBS评分显著优于B组与C组(P < 0.05)；各组FAC及Sheikh评分结果亦显示，D组综合表现最优。结论：在常规康复训练基础上，单独应用SET或RFE均能有效改善脑卒中偏瘫患者的下肢运动功能与核心稳定性；SET联合RFE的综合干预模式具有协同增效作用，其临床疗效显著优于单一疗法，是促进脑卒中偏瘫患者运动功能恢复的优选方案。

Abstract: Objective: This study aimed to investigate the effects of Kawahara Method (RFE) combined with Sling Exercise Training (SET) on lower extremity motor function in stroke patients with hemiplegia on the basis of conventional rehabilitation training, so as to optimize clinical intervention strategies and provide evidence-based references for functional recovery. Methods: Sixty hospitalized stroke patients meeting the inclusion criteria of Brunnstrom stage ≥III and 3 weeks to 6 months after stroke were enrolled. They were randomly divided into four groups using a random number table: conventional rehabilitation group (Group A), conventional rehabilitation + RFE group (Group B), conventional rehabilitation + SET group (Group C), and conventional rehabilitation + SET + RFE group (Group D). All groups received corresponding interventions for 4 weeks. Outcomes were evaluated by Fugl-Meyer Assessment of Lower Extremity (FMA-LE), Functional Ambulation Category (FAC), Berg Balance Scale (BBS), and Sheikh Trunk Control Test. Results: Intragroup comparison showed that all indexes were significantly improved after intervention in each group (Group A, P < 0.05; Groups B, C, D, P < 0.01). Intergroup analysis revealed that FMA-LE scores in Groups B and C were significantly higher than those in Group A (P < 0.05), and FMA-LE score in Group D was much more significantly higher than that in Group A (P < 0.01). For balance function, BBS score in Group D was significantly better than that in Groups B and C (P < 0.05). FAC and Sheikh scores also confirmed the best comprehensive performance in Group D. Conclusion: On the basis of conventional rehabilitation, either SET or RFE alone can effectively improve lower extremity motor function and core stability in stroke patients with hemiplegia. The combined intervention of SET and RFE shows a significant synergistic effect with better clinical efficacy than single therapy, which is a preferred strategy to promote motor function recovery in stroke patients with hemiplegia.