Objective:To investigate the effects of rehabilitation training on gait disorders and pain in Parkinson's disease,as well as to explore the correlation between gait improvement and pain.Methods:Fifty-five patients with Parkinson's disease were randomly divided into experimental group (27 cases)and control group (28 cases).Both groups were treated with routine medication,and the experimental group received rehabilitation training including bedside rehabilitation training such as Bobath and indoor rehabilitation training such as gait training following audio visual stimulation.UPDRS Ⅲ score,Berg balance scale (BBS),gait analysis and visual analogue scale (VAS)were assessed before and after treatment.Results:After training,the UPDRS Ⅲ score,BBS score,VAS scores and walking speed,step length,hip flexion angle were significantly improved in the experimental group (P<0.05). When compared with the control group,the experimental group performed better in the walking speed,hip flexion angle and double support phase,BBS and VAS (P<0.05).Furthermore,the maximum flexion angle of hip joint was related to VAS pain score and balance ability(r=—0.61,0.53,P<0.01)and there was a correlation between walking pace and VAS pain score,balance ability (r=—0.48,0.69;P<0.05,P<0.01),and a correlation be-tween double support phase and balance ability(r=—0.71,P<0.01).However,there was no correlation between the dual support phase and the VAS pain score (r=0.37,P>0.05).Conclusion:Effective rehabilitation training can alleviate pain,and improve the postural and gait abnormalities in Parkinson's disease.At the same time,there is a certain correlation between gait improvement and pain relief.%目的:探讨在药物治疗基础上康复训练治疗步态障碍及疼痛的临床疗效以及步态与帕金森病疼痛相关性.方法:帕金森病伴疼痛患者55例随机分为训练组27例和对照组28例,2组均常规采用药物治疗,训练组加用床边康复训练及室内康复训练等方面康复训练干预综合锻炼步态及平衡功能,治疗前后采用 UPDRS Ⅲ 评分、Berg平衡量表(BBS)、步态分析、视觉模拟评分法(VAS)等进行评定.结果:2周床边训练及4周室内步态平衡训练后,训练组患者步速、步长、髋关节屈曲最高角度、双支撑相、UPDRS Ⅲ 评分、BBS评分及 VAS评分与治疗前比较均存在统计学差异(均P<0.05);训练组患者在步速、髋关节屈曲最大角度、双支撑相、BBS评分及 VAS评分与对照组比较存在统计学意义(均P<0.05);对照组治疗前后各项指标比较差异无统计学意义.训练组患者髋关节屈曲最大角度与VAS疼痛评分、平衡能力存在相关性(r=—0.61、0.53,均P<0.01);步速与VAS疼痛评分、平衡能力存在相关性(r=—0.48、0.69,P<0.05、P<0.01);双支撑相与平衡能力存在相关性(r=—0.71,P<0.01);双支撑相与 VAS疼痛评分之间相关性无统计学意义(r=0.37,P>0.05).结论:帕金森病药物治疗基础上配合有效的康复训练,可明显改善患者姿势及步态异常,同时有利于疼痛减轻,且步态与疼痛之间存在一定的相关性.
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