Intensive simplified home-based task-oriented training in stroke patients with unilateral lower limb motor dysfunction: A preliminary application analysis / 中国脑血管病杂志

ABSTRACT

Objective: To investigate the preliminary application effect in intensive simplified home-based task-oriented training in stroke patients with unilateral lower limb motor dysfunction. Methods: From May 2016 to October 2018,30 chronic stage stroke patients with unilateral lower limb motor dysfunction for outpatient rehabilitation training at the Department of Rehabilitation Medicine,Xuanwu Hospital, Capital Medical University were enrolled retrospectively. According to the rehabilitation methods, 30 patients were divided into either a general rehabilitation training group (re = 15) or an intensive home-based task-oriented training group (re = 15). Both groups of patients underwent routine rehabilitation guidance at the rehabilitation medicine clinic (3 times a week) and intensive family rehabilitation training (2h/d) for 4 weeks. (1) The general rehabilitation training group used routine home rehabilitation training,including sloping board standing, standing up-sitting down, bending legs-stretching legs, standing forward and backward step training,and walking training under protection. The training frequency was 2 h/d,5 d/week. (2) In the family rehabilitation, the simplified task-oriented training group decomposes the " stepping" action into three exercises ankle joint eversion, hip knee flexion with ankle dorsiflexion, hip knee extension with ankle dorsiflexion. Fugl-Meyer motor assessment-lower extremity (FMA-LE), Berg Balance Scale (BBS),Timed Up and Go (TUG) test were compared before and after treatment. Results: (1) There were significant differences in FMA-LE scores, groups and time interaction before and after treatment between the two groups (F - 483. 64, P < 0. 01). The FMA-LE scores of the general rehabilitation training group before and after treatment were 20 ± 4 and 21 ±4 respectively, while those of the simplified task-oriented training group before and after treatment were 22 ± 4 and 25 ± 6 respectively. There were no significance before treatment between the two groups (P = 0.25). After treatment, the simplified task-oriented training group was superior to the general rehabilitation training group,and the difference between both groups was statistically significant (P = 0.003). The FMA-LE scores of the two groups were better than those of the groups before treatment. The differences before and after treatment were statistically significant (all P<0.01). (2) The BBS scores before and after treatment were compared,and there was significant difference in the groups and time interaction (F = 2 375. 69, P < 0. 01). The BBS scores of the general rehabilitation training group before and after treatment were 45. 3 ± 1. 0 and 46. 4 ± 1. 3 respectively, while those of the simplified task-oriented training group before and after treatment were 46.8 ± 1.4 and 49.7 ± 1.2 respectively. There was no significant difference in BBS scores between the two groups (P =0.09). The BBS scores of the two groups were better than those of the groups before treatment, and the differences before and after treatment were statistically significant (all P<0.01). (3) There were significant differences in TUG before and after treatment in the groups and time interaction (F = 259. 56, P < 0. 01). TUG of the general rehabilitation training group before and after treatment were 20.0 ±7. 1 and 19.3 ± 7. 5 s respectively, while TUG of the simplified task-oriented training group before and after treatment were 20. 9 ± 1. 6 and 16.9 ± 1.2s respectively. There was no significant difference in TUG between the two groups (P =0.79). There was no significant difference in TUG between the general rehabilitation group before and after treatment (P = 0. 11). The TUG of the simplified task-oriented training group was shorter than that before treatment,and the difference was statistically significant before and after treatment (P<0.01). Conclusions: Intensive simplified home-based task-oriented training and intensive home-based general rehabilitation training are helpful to improve lower limb basic motor function, balance function, and motor control ability in patients with chronic lower limb motor dysfunction. Intensive simplified home-based task-oriented training is slightly superior to intensive home-based general rehabilitation training in improving basic motor function of lower limbs. The two training methods have similar effects in terms of balance function and walking speed.