國科會專題計畫成果報告:早期步行器訓練對中風病人步行能力之效果: 肌電圖與運動學之分析

Abstract

本研究比較使用步行器與使用傳統物 理治療方法對中風病人步行訓練的效果。 共十一位中風病人參與此計劃，但完成計 劃之全程者只有七位，其中四位為控制 組，三位為實驗組。兩組受試者都接受為 期五週、每週至少三次的物理治療。治療 時控制組所接受的步行訓練為以神經生理 學為基礎之步行訓練，實驗組則接受步行 器步行訓練。在訓練前、訓練後、及訓練 後一個月，研究者測試受試者的步行功 能、步態、以及日常生活自理能力，並用 重覆性共變數分析比較實驗組與控制組於 三次測試時在這些變項上的差異。結果顯 示兩組人在訓練前、訓練後、及訓練後一 個月的步行功能、步態、以及日常生活自 理能力並無顯著差異。過去的研究顯示， 密集的步行器步行訓練比密集的傳統物理 治療步行訓練效果為佳。但本研究發現： 以一般的臨床治療量給予步行器步行訓練 時，其訓練結果並未優於傳統之物理治療 步行訓練。因此，建議物理治療師們在使 用步行器作步行訓練時，應審慎選擇合適 的治療量，以充分發揮步行器步行訓練的 療效。

This study compared the effectiveness of treadmill training and conventional physical therapy training on improving ambulatory ability, gait pattern, and functional independence of stroke patients. Eleven stroke patients participated in the study, but only seven completed the study. There were four subjects in the control group and three subjects in the experimental group. Both groups received a five-week physical therapy program with a minimum of three sessions every week. The control group received ambulation training based on knowledge in neurophysiology, whereas the experimental group received treadmill training. Ambulatory function, gait patterns, and level of independence in performing daily activities were compared between the groups before, immediately after, and one-month after training. The results did not reveal any significant group difference on these gait and functional measures across the three tests. Past research has shown that intensive treadmill training results in better improvement in gait velocity than intensive conventional therapy. The present study, however, showed that treadmill training with moderate intensity did not produce better effectiveness than conventional therapy of similar intensity. It is suggested that when treadmill training is used as the primary gaittraining program for stroke patients, an appropriate intensity should be chosen for this type of training to show superior treatment effects.