Effect of Tai chi posture training combined with Bobath therapy on gait rehabilitation in ischemic stroke patients with hemiplegia
Objective It is to explore the effect of Tai chi posture training combined with Bobath therapy on gait reha-bilitation in ischemic stroke patients with hemiplegia.Methods One hundred and twenty patients with ischemic stroke and hemiplegia treated in Dongzhimen Hospital of Beijing University of Chinese Medicine and Huairou District Hospital of Tradi-tional Chinese Medicine from April 2017 to April 2022 were randomly divided into test group and control group.The pa-tients in the control group were treated with Bobath therapy training,the patients in the test group were treated with Tai chi posture training and Bobath therapy training,both groups were treated for 4 weeks.The pressure trail test was performed at the time of enrollment and 4 weeks after treatment.The whole foot balance,plantar mechanical parameters[impulse,ground contact area,peak maximum force,peak maximum pressure of phalangeal area(T1-T5),metatarsal area(M1-M5),middle foot area,medial heel area(HM),lateral heel area(HL)]and basic time and space parameters[step length,stride length,stride width,stride speed,walking support phase,foot axis angle],clinical scale score[including National Institutes of Health Stroke scale(NIHSS),Fugl-Meyer rating scale(FMA),Berg balance scale(BBS),Bathel Index(BI),Modified Rankin Scale(mRS),Stroke-Specific of Life scale(SSQOL)],muscular tension[Modified Ash-worth rating Scale,Brunnstrom rating Scale]of patients in the two groups were analyzed and compared,and the correlation of these indexes with statistically significant differences between the two groups was analyzed.Results The study was com-pleted in 50 cases in the test group and 50 cases in the control group.After treatment in the test group,the whole foot bal-ance curve was more smoother,the peak pressure of T2-5 toe and M1 and M2 and the ground contact area of T1 were signif-icantly increased,and the foot axis angle was decreased(all P<0.05).The whole foot balance curve of the control group was separated,the ground contact area of M3 was increased,and the ground contact area and impulse of HL were decreased(all P<0.05).The walking speed were increased,the supporting phase and gait cycle of the affected side were short-ened,and the step length and stride were increased in both groups,and the differences were all statistically significant(all P<0.05).After treatment,the peak maximum pressure,step length and stride length of the test group were obviously lar-ger than those of the control group,the ground contact area and foot axis angle of M3 were significantly smaller than those of the control group,and the walking speed was significantly faster than that of the control group,the support phase and gait cycle of the affected side were significantly shorter than those of the control group,Ashworth grade,Brunnstrom lower limb grade and mRS score were significantly lower than those of the control group,while FMA score,Berg score and BI score of lower limbs were significantly higher than those of the control group,the differences were all statistically significant(all P<0.05).Conclusion Tai chi posture training combined with Bobath therapy can redistribute the plantar pressure of ischemic stroke patients with hemiplegia,and effectively improve their balance ability and walking ability.
walking abilityischemic strokehemiplegic gaitTai chi posture training
万方数据
维普
