倒踩腳踏車訓練對中風後僵硬膝關節步態之療效：兩個案報告

背景與目的：僵硬膝關節步態是腦中風患者常見的動作問題，針對此問題，目前尚無明確的治療方法，由於腳踏車踩踏方向和轉速具有影響股四頭肌與膕旁肌肌力與活化時間之特性，因此本研究目的為探討45 revolutions per minute （RPM）倒踩腳踏車訓練對於僵硬膝關節步態中風患者之行走功能改善的效果。方法：本研究納入2位中風個案，2個案除接受一般物理治療訓練之外，額外接受12次45 RPM的倒踩腳踏車訓練（每次50 min、每週3次，共4週）。分別於訓練前、後接受行走和臨床功能評估。結果：訓練後2位個案於行進間患側膝關節彎曲角度提升且膝彎曲時間點趨近健康人的表現，行走時肌電圖顯示訓練後股四頭肌與膕旁肌的收縮節律趨於明顯，雙腳步長增加，對稱性指數大幅改善。此外，計時起步測試亦有進步。結論：使用45 RPM模式的倒踩腳踏車訓練或許可安全有效的達到改善中風患者僵硬膝關節步態之效益。

關鍵字

中風；僵硬膝關節步態；倒踩腳踏車

並列摘要

Background and Purpose: Stiff knee gait (SKG) is a common problem in people with stroke. So far, it still lacks effective interventions for SKG. Past studies have found that pedaling direction and revolution can affect the muscle strength and activation time of the quadriceps and hamstrings. This study aimed to examine the effects of 45 revolutions per minute (RPM) reversed cycling training on walking function in individuals with post-stroke SKG. Methods: This study recruited two participants. They underwent general physiotherapy and 45 RPM reversed cycling training for 12 sessions (50 min each session, three sessions per week for total four weeks). Walking performance and clinical functional assessments were evaluated at before and after training. Results: After training, both participants showed an improvement in the degree of knee flexion on the affected side during walking and the timing of knee flexion was similar to healthy adults. The muscles contraction rhythm tended to be more obvious in quadriceps and hamstrings by walking electromyography. Bilateral step length was increased and symmetry index was improved. Additionally, results from the Timed Up and Go test showed improvement. Conclusions: The 45 RPM reversed cycling training may improve safely and effectively the SKG in people with stroke.

並列關鍵字

Stroke ； Stiff knee gait ； Reversed cycling training

國際替代計量

倒踩腳踏車訓練對中風後僵硬膝關節步態之療效：兩個案報告

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