A prospective randomized controlled study on the effects of progressive core muscle group training combined with lower limb intelligent rehabilitation training for burn patients with lower limb dysfunction

Zhao Haiyang; Liu Jiaqi; Han Juntao; Zhu Chan; Zhou Qin; Xu Jing; Liang Min; Zhang Bowen; Qi Zongshi

doi:10.3760/cma.j.cn501225-20220616-00236

Volume 38 Issue 12

Dec. 2022

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Article Navigation > CHINESE JOURNAL OF BURNS AND WOUNDS > 2022 > 38(12): 1117-1125

Zhao HY,Liu JQ,Han JT,et al.A prospective randomized controlled study on the effects of progressive core muscle group training combined with lower limb intelligent rehabilitation training for burn patients with lower limb dysfunction[J].Chin J Burns Wounds,2022,38(12):1117-1125.DOI: 10.3760/cma.j.cn501225-20220616-00236.

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A prospective randomized controlled study on the effects of progressive core muscle group training combined with lower limb intelligent rehabilitation training for burn patients with lower limb dysfunction

doi: 10.3760/cma.j.cn501225-20220616-00236

Department of Burns and Cutaneous Surgery, Burn Center of PLA, the First Affiliated Hospital of Air Force Medical University, Xi'an 710032, China

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Shaanxi Provincial Key Research and Development Plan 2022SF-279

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Corresponding author: Liu Jiaqi, Email: anlhw07@fmmu.edu.cn
Received Date: 2022-06-16

Abstract

Abstract

Objective To observe the effect of progressive core muscle group training combined with lower limb intelligent rehabilitation training on burn patients with lower limb dysfunction. Methods A prospective randomized controlled study was conducted. From March 2017 to May 2020, 60 patients with motor and balance dysfunction after deep partial-thickness burns or full-thickness burns of both lower extremities who met the inclusion criteria were admitted to the First Affiliated Hospital of Air Force Military Medical University. They were divided into simple intelligent rehabilitation group (30 cases, 20 males and 10 females, aged (40±3) years) and combined rehabilitation group (30 cases, 16 males and 14 females, aged (39±3) years) according to the random number table method. The patients in both groups started red light treatment after the wound healing or when the scattered residual wound area was less than 5% total body surface area. After 2 weeks of red light treatment, patients in the combined rehabilitation group started progressive core muscle group training on the basis of lower limb intelligent rehabilitation training in simple intelligent rehabilitation group, and the training time was 6 weeks. Before and after 6 weeks of training, the lower limb motor function was evaluated with the simple Fugl-Meyer scale, the balance capacity was evaluated with the Berg balance scale, and the walking capacity was evaluated with the Holden walking ability rating scale. After 6 weeks of training, a self-designed questionnaire was used to investigate patients' satisfaction for the treatment effect. The patients were followed up for 6 months after the treatment to observe the balance stability of standing on one foot in the flexion position and their participation in activities of daily life. Data were statistically analyzed with independent sample t test, paired sample t test, and chi-square test. Results Before training, the lower limb motor function score of patients in simple intelligent rehabilitation group was 24.9±2.7, which was close to 23.9±2.3 in combined rehabilitation group (P>0.05). After 6 weeks of training, the lower limb motor function score of patients in combined rehabilitation group was 29.6±3.9, which was significantly higher than 27.3±3.8 in simple rehabilitation group (t=-2.28, P<0.05). The lower limb motor function scores of patients in combined rehabilitation group and simple intelligent rehabilitation group after 6 weeks of training were significantly higher than those before training (with t values of -6.50 and -3.21, respectively, P<0.01). After 6 weeks of training, the balance capacity score of patients in combined rehabilitation group was 41±7, which was significantly higher than 36±5 in simple intelligent rehabilitation group (t=-2.68, P<0.05); the balance capacity scores of patients in combined rehabilitation group and simple intelligent rehabilitation group after 6 weeks of training were significantly higher than those before training (with t values of -8.72 and -8.09, respectively, P<0.01). After 6 weeks of training, the walking capacity grading of patients in combined rehabilitation group was significantly improved compared with that in simple intelligent rehabilitation group (χ²=-2.14, P<0.05), and the walking capacity grading of patients in simple intelligent rehabilitation group and combined rehabilitation group after 6 weeks of training was significantly improved compared with that before treatment (with χ² values of -4.94 and -5.26, respectively, P<0.01). After 6 weeks of training, the satisfaction score for the treatment effect of patients in combined rehabilitation group was 13.7±1.2, which was significantly higher than 7.8±1.4 in simple intelligent rehabilitation group (t=22.84, P<0.01). The patients in both groups could stand on one foot to maintain balance in the flexion position of lower limb, and their activities of daily life were not affected 6 months after treatment. Conclusions On the basis of conventional rehabilitation therapy, the combination of progressive core muscle group training and lower limb intelligent rehabilitation training can significantly promote the recovery of lower limb motor and balance function of burn patients.
- Burns,
- Rehabilitation,
- Lower extremity,
- Progressive core muscle group training,
- Motor function

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References(37)

References

[1]	ReddyS,El-HaddawiF,FancourtM,et al.The incidence and risk factors for lower limb skin graft failure[J].Dermatol Res Pract,2014,2014:582080.DOI: 10.1155/2014/582080.
[2]	FufaDT,ChuangSS,YangJY.Postburn contractures of the hand[J].J Hand Surg Am,2014,39(9):1869-1876.DOI: 10.1016/j.jhsa.2014.03.018.
[3]	GrisbrookTL,ReidSL,EdgarDW,et al.Exercise training to improve health related quality of life in long term survivors of major burn injury: a matched controlled study[J].Burns,2012,38(8):1165-1173.DOI: 10.1016/j.burns.2012.03.007.
[4]	LeventhalD,FurrM,ReiterD.Treatment of keloids and hypertrophic scars: a meta-analysis and review of the literature[J].Arch Facial Plast Surg,2006,8(6):362-368.DOI: 10.1001/archfaci.8.6.362.
[5]	RingHC,MogensenM,HussainAA,et al.Imaging of collagen deposition disorders using optical coherence tomography[J].J Eur Acad Dermatol Venereol,2015,29(5):890-898.DOI: 10.1111/jdv.12708.
[6]	CulmerPR, JacksonAE, MakowerS,et al. A control strategy for upper limb robotic rehabilitation with a dual robot system[J]. IEEE/ASME Transactions on Mechatronics, 2010, 15(4):575-585. DOI: 10.1109/TMECH.2009.2030796.
[7]	YapHK,LimJH,NasrallahF,et al.Characterisation and evaluation of soft elastomeric actuators for hand assistive and rehabilitation applications[J].J Med Eng Technol,2016,40(4):199-209.DOI: 10.3109/03091902.2016.1161853.
[8]	BombaroKM,EngravLH,CarrougherGJ,et al.What is the prevalence of hypertrophic scarring following burns?[J].Burns,2003,29(4):299-302.DOI: 10.1016/s0305-4179(03)00067-6.
[9]	Van CriekingeT,SaeysW,HallemansA,et al. Effectiveness of additional trunk exercises on gait performance: study protocol for a randomized controlled trial[J].Trials,2017,18(1):249.DOI: 10.1186/s13063-017-1989-1.
[10]	SilfiesSP,EbaughD,PontilloM,et al.Critical review of the impact of core stability on upper extremity athletic injury and performance[J].Braz J Phys Ther,2015,19(5):360-368.DOI: 10.1590/bjpt-rbf.2014.0108.
[11]	佟琳,张万福,胡晓龙,等.腹部不同位置全厚皮片修复小儿功能部位皮肤软组织缺损的前瞻性随机对照研究[J].中华烧伤与创面修复杂志,2022,38(8):744-752.DOI: 10.3760/cma.j.cn501120-20210709-00243.
[12]	赵海洋,王洪涛,朱婵,等.窄谱中波紫外线与红光和低功率He-Ne激光联合治疗烧伤后湿疹的临床疗效观察[J].中华烧伤杂志,2018,34(12):881-886.DOI: 10.3760/cma.j.issn.1009-2587.2018.12.012.
[13]	LiP,Li-TsangCWP,DengX,et al.The recovery of post-burn hypertrophic scar in a monitored pressure therapy intervention programme and the timing of intervention[J].Burns,2018,44(6):1451-1467.DOI: 10.1016/j.burns.2018.01.008.
[14]	ChenIC,ChengPT,ChenCL,et al.Effects of balance training on hemiplegic stroke patients[J].Chang Gung Med J,2002,25(9):583-590.
[15]	杨文元.温水下运动训练对特重度烧伤患者下肢运动功能的影响[J].中国疗养医学,2020,29(1):24-25.DOI: 10.13517/j.cnki.ccm.2020.01.008.
[16]	AaronSE,HunnicuttJL,EmbryAE,et al.POWER training in chronic stroke individuals: differences between responders and nonresponders[J].Top Stroke Rehabil,2017,24(7):496-502.DOI: 10.1080/10749357.2017.1322249.
[17]	EmersonRSW. Likert scales[J]. Journal of Visual Impairment &Blindness, 2017, 111(5): 488. DOI: 10.1177/0145482X1711100511.
[18]	张祥运.早期整形手术治疗老年深Ⅱ度烧伤患者创面愈合后瘢痕挛缩畸形和关节功能障碍的临床疗效[J].中国老年学杂志,2017,37(3):683-684.DOI: 10.3969/j.issn.1005-9202.2017.03.071.
[19]	YangSX, ChengS, SuDL.Sports injury and stressor-related disorder in competitive athletes: a systematic review and a new framework[J/OL]. Burns Trauma, 2022,10:tkac017[2022-11-20]. https://pubmed.ncbi.nlm.nih.gov/35702266/. DOI: 10.1093/burnst/tkac017.
[20]	LvK,LiuH,XuH,et al.Ablative fractional CO2 laser surgery improving sleep quality, pain and pruritus in adult hypertrophic scar patients: a prospective cohort study[J/OL].Burns Trauma,2021,9:tkab023[2022-11-20]. https://pubmed.ncbi.nlm.nih.gov/34322556/.DOI: 10.1093/burnst/tkab023.
[21]	SimonsM,KingS,EdgarD.Occupational therapy and physiotherapy for the patient with burns: principles and management guidelines[J].J Burn Care Rehabil,2003,24(5):323-335; discussion 322.DOI: 10.1097/01.BCR.0000086068.14402.C6.
[22]	朱婵,易南,石梦娜,等.功能训练联合自制手屈曲训练带治疗手背部烧伤后瘢痕挛缩的效果观察[J].中华烧伤杂志,2017,33(7):426-430.DOI: 10.3760/cma.j.issn.1009-2587.2017.07.007.
[23]	SerghiouMA,NiszczakJ,ParryI,et al.Clinical practice recommendations for positioning of the burn patient[J].Burns,2016,42(2):267-275.DOI: 10.1016/j.burns.2015.10.007.
[24]	ParkYL,ChenBR,Pérez-ArancibiaNO,et al.Design and control of a bio-inspired soft wearable robotic device for ankle-foot rehabilitation[J].Bioinspir Biomim,2014,9(1):016007.DOI: 10.1088/1748-3182/9/1/016007.
[25]	RadderB,Prange-LasonderGB,KottinkAIR,et al.Home rehabilitation supported by a wearable soft-robotic device for improving hand function in older adults: a pilot randomized controlled trial[J].PLoS One,2019,14(8):e0220544.DOI: 10.1371/journal.pone.0220544.
[26]	赵海洋,韩军涛,刘佳琦,等.手持续被动运动系统联合功能训练与压力手套治疗手背部烧伤后早期瘢痕挛缩的效果[J].中华烧伤杂志,2021,37(4):319-326.DOI: 10.3760/cma.j.cn501120-20201020-00443.
[27]	KiblerWB,PressJ,SciasciaA.The role of core stability in athletic function[J].Sports Med,2006,36(3):189-198.DOI: 10.2165/00007256-200636030-00001.
[28]	CugliariG,BocciaG.Core muscle activation in suspension training exercises[J].J Hum Kinet,2017,56:61-71.DOI: 10.1515/hukin-2017-0023.
[29]	ChevidikunnanMF,Al SaifA,GaowgzehRA,et al.Effectiveness of core muscle strengthening for improving pain and dynamic balance among female patients with patellofemoral pain syndrome[J].J Phys Ther Sci,2016,28(5):1518-1523.DOI: 10.1589/jpts.28.1518.
[30]	张慧,闫玮娟,李远征.KLW-SKF智能康复训练系统在神经系统疾病肢体瘫痪治疗中的应用[J].实用医药杂志,2013,30(11):982.
[31]	ZátopkováL,HejnaP,PalmiereC,et al.Hypothermia provokes hemorrhaging in various core muscle groups: how many of them could we have missed?[J].Int J Legal Med,2017,131(5):1423-1428.DOI: 10.1007/s00414-017-1596-4.
[32]	KhaiyatOA,NorrisJ.Electromyographic activity of selected trunk, core, and thigh muscles in commonly used exercises for ACL rehabilitation[J].J Phys Ther Sci,2018,30(4):642-648.DOI: 10.1589/jpts.30.642.
[33]	茹天峰, 李菲虹, 谢卫国, 等. 平衡训练联合常规治疗对严重烧伤后下肢运动及平衡功能障碍患者影响的前瞻性随机对照研究 [J]. 中华烧伤杂志, 2021, 37(4):312-318. DOI: 10.3760/cma.j.cn501120-20201018-00441.
[34]	AlmajidR,GoelR,TuckerC,et al.Balance confidence and turning behavior as a measure of fall risk[J].Gait Posture,2020,80:1-6.DOI: 10.1016/j.gaitpost.2020.05.020.
[35]	KeserI,KirdiN,MericA,et al.Comparing routine neurorehabilitation program with trunk exercises based on Bobath concept in multiple sclerosis: pilot study[J].J Rehabil Res Dev,2013,50(1):133-140.DOI: 10.1682/jrrd.2011.12.0231.
[36]	MikołajewskaE. The value of the NDT-Bobath method in post-stroke gait training[J]. Adv Clin Exp Med, 2013,22(2):261-272.
[37]	HidesJA,EndicottT,MendisMD,et al.The effect of motor control training on abdominal muscle contraction during simulated weight bearing in elite cricketers[J].Phys Ther Sport,2016,20:26-31.DOI: 10.1016/j.ptsp.2016.05.003.