截瘫步行器对截瘫患者日常生活活动能力的影响

Influence of reciprocating gait orthosis on the activities of daily living in paraplegic patients

目的:应用自行研制的截瘫步行器(RGO),配合综合系统康复治疗,帮助脊髓损伤截瘫患者提高日常生活活动自理能力。方法:先后为16例T4-L1节段完全性脊髓损伤患者安装RGO,并于安装前后对其进行关节活动度、肌肉力量、平衡转移、站立和行走等综合康复训练。结果:16例截瘫患者装配RGO前后改良Barthel指数(MBI)分别为35.26±11.49分和58.69±15.75分;功能独立性测评(FIM)得分分别为57.64±16.37分和82.73±21.69分,其装配前后的MBI和FIM得分差异均有显著性意义(P<0.05);患者装配RGO后的MBI和FIM移动能力得分与安装前比较差异亦有显著性意义。11例患者达到功能性步行,5例可作治疗性步行。结论:完全性脊髓损伤患者可以应用RGO提高日常生活活动能力。RGO可以帮助截瘫患者实现功能性步行,提高生存质量。

Objective： To evaluate the application of self-manufactured reciprocating gait orthosis （RCO） with systemic rehabilitation to improve the activities of daily living （ADL） of spinal cord injured （SCI） patients. Method： Sixteen paraplegic patients with complete spinal cord injury of lesion level between T4 and L1 were fitted up with RGO. Exercises of range of motion, strength, transfering,balancing,standing and walking items were conducted with the aid of RGO. Result： Before and after fitting RGO, the MBI score of these 16 paraplegic patients were 35.26± 11.49 and 58.69±15.75, and FIM 57.64±16.37 and 82.73±21.69 respectively. There were significant differences between these data （P〈0.05）. There were also significant differences between the data from their mobility scores of MBI and FIM before and after therapy. Eleven cases achieved functional ambulation, and 5 cases therapeutic ambulation. Conclusion： With the aid of RGO, paraplegic patients suffered from complete spinal cord injury can improve their activities of daily living. RGO can help paraplegic patients to achieve functional walking and improve their quality of life. It is worthy of applying RGO in a wide range in clinical rehabilitation for patients with paraplegia.