山东医药

目的 观察改良“野马分鬃”训练对脑卒中患者下肢运动障碍的康复效果，为脑卒中下肢运动障碍的临床康复治疗提供科学依据和实践方案。方法 选择脑卒中下肢运动功能障碍患者72例，采用随机数字表法分为观察组和对照组，每组36例。两组均予常规康复锻炼，包括关节活动度训练、肌力训练、平衡训练、步行训练等，观察组在此基础上联合改良“野马分鬃”训练，每天1次，每周5次，连续3周。治疗前后分别采用Fugl-Meyer下肢功能评定量表（FMA-LE）、Berg平衡量表（BBS）、改良Barthel指数（MBI）、Holden步行功能量表（FAC）分级评估患者下肢运动功能、平衡能力、日常生活活动能力及步行功能，采用三维步态分析系统观察患者步态情况（时空参数及运动学参数）。结果 与治疗前相比，治疗后两组FMA-LE评分、BBS评分、MBI评分、FAC分级均提高，步长、步频、步速及患侧单腿支撑相比例均增加，三维步态下肢关节运动学参数均改善（P均<0.05）。与对照组相比，治疗后观察组FMA-LE评分、BBS评分、MBI评分、FAC分级均提高，步长、步频、步速及患侧单腿支撑相比例增加，三维步态下肢关节运动学参数均改善（P均<0.05）。结论 改良“野马分鬃”训练对脑卒中患者下肢运动障碍的康复效果较好，可改善患者下肢运动功能、平衡能力和步态，提升日常生活自理能力。

Objective To evaluate the rehabilitation effect of modified Yema Fenzong(Parting the Wild Horse's Mane) training on lower limb motor dysfunction in stroke patients and to provide clinical evidence and practical protocols for post-stroke rehabilitation. Methods Seventy-two patients with post-stroke lower limb motor dysfunction were assigned into the observation group and control group using a random number table, with 36 cases in each group. Patients in both groups received conventional rehabilitation training, including range of motion training, muscle strength training, balance training, and gait training, while patients in the observation group received additionally modified Yema Fenzong training. All interventions were administered once daily, 5 times per week, for 3 consecutive weeks. Before and after treatment, lower limb motor function, balance, activities of daily living, and walking function were assessed using the Fugl-Meyer Assessment of Lower Extremity(FMA-LE), Berg Balance Scale(BBS), Modified Barthel Index(MBI), and Holden Functional Ambulation Classification(FAC). Three-dimensional gait analysis system was used to evaluate gait recovery(spatiotemporal parameters and kinematic parameters). Results After treatment, both groups showed significant improvements in FMA-LE, BBS, MBI, FAC, and step length, cadence, walking speed, and single-leg stance phase ratio as compared with those before treatment(all P<0. 05), and all three-dimensional gait kinematic parameters of the lower extremity joints improved. Compared with the control group, the observation group exhibited higher FMA-LE, BBS, and MBI scores, better FAC grade, longer step length, higher cadence, faster walking speed, as well as single-leg stance phase ratio, and all threedimensional gait kinematic parameters of the lower extremity joints improved(all P<0. 05). Conclusions Modified Yema Fenzong training yields favorable rehabilitation outcomes for lower limb motor dysfunction in stroke patients. It enhances lower limb motor function, balance, and gait performance, and improves patients' ability to perform activities of daily living.