中枢整合治疗技术结合环境设计纠正偏瘫异常步态的临床研究

Clinical Research on Central Integration Therapy Combined with Environmental Design to Correct Abnormal Gait in Hemiplegia

摘要: 目的：探究中枢整合治疗技术结合环境设计对脑卒中后偏瘫患者异常步态的临床治疗效果，分析该联合疗法对患者下肢运动功能、平衡能力及日常步行功能的改善作用，为临床脑卒中偏瘫步态康复治疗提供参考。方法：选取2025年1月~2026年5月黑龙江省海员总医院运动治疗科收治的60例脑卒中后偏瘫患者为研究对象，采用随机数字表法分为试验组与对照组，各30例。对照组予以临床常规康复干预治疗，试验组在对照组基础上加中枢整合治疗技术联合环境设计康复，两组患者均连续干预28 d。分别于干预前、干预1周、干预2周、干预4周记录Fugl-Meyer下肢运动功能评分(FMA-LE)、Berg平衡量表(BBS)、起立–行走计时测试(TUGT)、功能独立性评定(FIM)、改良Barthel指数(MBI)，同时观察两组干预期间不良事件发生情况。结果：干预前，两组患者FMA-LE、BBS、TUGT、FIM、MBI各项功能指标基线数据对比无统计学差异(P > 0.05)，组间具备可比性；干预1周、2周、4周后，两组患者各项功能指标均较治疗前显著改善，且试验组患者下肢运动功能、平衡能力、步行效率及日常生活自理能力改善幅度显著优于对照组，组间数据差异均具有统计学意义(P < 0.05)。两组干预期间均无严重不良事件发生，轻微不适发生率对比无统计学差异(P > 0.05)。结论：中枢整合治疗技术结合环境设计的联合干预方案，可有效修复脑卒中后偏瘫患者下肢运动功能，改善机体平衡能力，矫正异常步行步态，显著提升患者日常生活独立能力，且干预方式安全可靠、无明显不良反应，康复疗效显著优于常规康复治疗，值得临床推广。

Abstract: Objective: To explore the clinical efficacy of central integration therapy combined with environmental design in treating abnormal gait in patients with post-stroke hemiplegia, and to analyze the improvement effects of this combined therapy on lower limb motor function, balance ability, and daily walking function of patients, providing a reference for clinical rehabilitation treatment of post-stroke hemiplegic gait. Methods: Sixty patients with post-stroke hemiplegia admitted to the Motor Therapy Department of Heilongjiang Maritime General Hospital from January 2025 to May 2026 were selected as the study subjects and divided into an experimental group and a control group using a random number table method, with 30 patients in each group. The control group received clinical conventional rehabilitation intervention therapy, while the experimental group received central integration therapy combined with environmental design rehabilitation on top of the control group’s treatment. Both groups underwent continuous intervention for 28 days. The Fugl-Meyer Assessment of Lower Extremity Motor Function (FMA-LE), Berg Balance Scale (BBS), Timed Up and Gait Test (TUGT), Functional Independence Measure (FIM), and Modified Barthel Index (MBI) were recorded before intervention, and at 1, 2, and 4 weeks after intervention. The occurrence of adverse events during the intervention period was also observed in both groups. Results: Before intervention, there were no statistically significant differences in baseline data of FMA-LE, BBS, TUGT, FIM, and MBI between the two groups (P > 0.05), indicating comparability between the groups. After 1, 2, and 4 weeks of intervention, all functional indicators in both groups significantly improved compared to before treatment. The experimental group showed significantly better improvements in lower limb motor function, balance ability, walking efficiency, and activities of daily living (ADL) compared to the control group, with statistically significant differences between the groups (P < 0.05). No serious adverse events occurred during the intervention period in both groups, and there was no statistical difference in the incidence of minor discomfort (P > 0.05). Conclusion: The combined intervention program of central integration therapy combined with environmental design can effectively repair lower limb motor function in patients with post-stroke hemiplegia, improve body balance ability, correct abnormal walking gait, and significantly enhance patients’ ADL ability. The intervention method is safe and reliable, with no significant adverse reactions, and the rehabilitation efficacy is significantly better than conventional rehabilitation therapy, making it worthy of clinical promotion.