Clinical Observation Of Taijiquan Posture Training In Improving Walking Ability Of Hemiplegic Patients With Cerebral Infarction

BACKGROUND:Stroke is the primary cause of adult disability in China,which is characterized by high disability rate.Cerebral infarction patients often left with different degrees of limb dysfunction,especially lower limb walking ability disorders,hemiplegia gait is one of its typical manifestations.Tai Chi is applied to the rehabilitation of walking ability of hemiplegia patients with cerebral infarction.Its effect is similar to that of modern limb rehabilitation techniques.However,most of the current studies on Tai Chi are based on traditional Tai Chi routines,which is difficult to be applied to patients with severe dysfunction after stroke,and the scope of improvement of dysfunction is limited.Therefore,this study analyzed the key postures in Tai Chi routines to improve motor function,and combined with the functional characteristics of stroke hemiplegia patients,simplified and decomposed the traditional Tai Chi on the basis of the traditional Tai Chi,so that it can be applied to stroke patients with different stages of dysfunction,and observed its efficacy.OBJECTIVE:To observe the clinical effect of Tai Chi Posture Training combined with modern rehabilitation training on improving walking ability of patients with cerebral infarction.METHOD:A total of 110 patients with cerebral infarction hemiplegia who met the dia gnostic criteria were randomly divided into control group(n=55)and experimental group(n=55).The control group received modern rehabilitation training with Bobath method as the main training.The experimental group added Tai Chi posture training on the basis of modern rehabilitation training.The 24 simplified Tai Chi posture traini ng was adopted as the posture standard,and the traditional Tai Chi posture training was improved and modified,and 6 of them were selected as the main training posture s.The treatment period was 4 weeks.Biomechanical indicators(total foot balance,gait speed,affected side step length,step width,stride length,affected side support time,swing time,gait period,affected side foot axial Angle)and clinical scale score were compared before and after treatment(motor function evaluation scale:Fugl-MeyerAsse ssment Extremity Scale FMA,Berg balance scale:BergBalanceScale,BBS,the United States national institutes of health stroke score:NationallnstituteofHealthStrokeScale,NIHSS,modified Rankin scale:ModifiedRankinScale,mRS,daily life activities ability scale:BathalIndex,BI,quality of life scale for stroke:QualityOfLifetableforstrokeSpecial ization,SS-QOL).The primary efficacy index was the balance of the whole foot,an d the secondary efficacy index was other biomechanical indexes and clinical scale scor es.The results of all the efficacy indicators were statistically analyzed.The efficacy bef ore and after treatment in each group was analyzed by comparing the indicators withi n the group,and the superior efficacy of the treatment scheme was discussed by com paring the two groups.RESULTS:1.Comparison between the experimental group and the control group in their respective groups:the two groups were significantly improved in step speed(P<0.01),step length and stride length(P<0.05),and the gait parameters with support time and reduced foot axis Angle(P<0.01).Full foot balance was also improved as a primary outcome measure.The step width of the affected side was significantly reduced compared with that before treatment,and the reduction in the experimental group was more significant(P<0.05),while the reduction in the control group was not statistically significant(P>0.05).In terms of scale scores,FMA and BBS scores of the affected side increased after treatment in both groups,while NHISS and mRS scores decreased significantly compared with those before treatment.Because the two groups adopted the same basic treatment,they had good parallelism.2.Comparison between groups after treatment:in terms of gait parameters:the main efficacy index,the balance of the whole foot,the effective rate of the experimental group was higher than that of the control group(P<0.05),and the balance of the whole foot was more normal,which was shown in less varus than that of the control group,which corrected the spastic gait of the lower limbs of stroke patients.Compared with the control group,the step speed of the experimental group increased more significantly(P<0.01),the step length and stride length of the affected side in the experimental group increased more significantly(P<0.01),the supporting time of the affected side in the experimental group shortened more significantly(P<0.01),and the foot axial Angle in the experimental group decreased more significantly(P<0.01).Scale score:after treatment,FMA score and BBS score in the experimental group were significantly higher than those in the control group,the difference was statistically significant(P<0.01).Compared with the control group,NHISS and mRS scores in the experimental group were decreased with statistically significant significance(P<0.01),and BI and SSQOL scores in the experimental group were increased with statistically significant significance(P<0.01).CONCLUSION:1.Tai Chi Postural Training combined with modern rehabilitation training and simple modern rehabilitation training can effectively improve the walking ability of patients with cerebral infarction hemiplegia.2.The effect of Tai Chi Postural Training combined with modern rehabilitation training is obviously better than that of.modern rehabilitation training alone.