踝足矫形器对脑性瘫痪患儿步态功能的改善作用

Ankle-foot orthosis improves gait function of children with cerebral palsy

脑性瘫痪主要影响患儿的行走功能,出现异常低效的步态模式,矫形器是用于改变神经肌肉和骨骼系统的机能特性或结构的体外使用装置,在矫形器治疗中使用最多的是踝足矫形器。踝足矫形器能够在踝足矢状面、冠状面、水平面3个平面提供合理的运动控制,保持关节的力线排列,促进功能,改善步态,是脑瘫患儿改善步态较为理想的矫形器。踝足矫形器在使用时也存在一些问题,比如关节活动范围受限,导致肌肉功能受限,因为加重了局部皮肤受压,容易引起感染等。正因为有这些不足,多年来临床医生与科研工作者一直在寻求各种各样的改良方式,如在现有标准踝足矫形器作用的基础上,附加某些治疗或保护性功能,以期获得更好的临床效果。为患者设计与装配最为合适的、个性化的踝足矫形器,是矫形器制作和设计的发展发向。

Cerebral palsy greatly affects walking function of the child patients, showing low-effective walking gait. Orthosis is used to change function features or structures of nerve, muscle and skeletal system. Ankle-foot orthosis is commonly used, which could provide appropriate movement control on sagittal, coronal and horizontal planes, maintain joint line of force arrangement, promote functions and improve gait. However, ankle-foot orthosis exhibits some limitations, such as limited range of joint motion, limited muscle function, and infection due to local skin compression. Therefore, clinical doctors and researches are looking for improvements over the past years, for example, to supplement some treatment or protective function based on current orthosis, so as to obtain better clinical outcomes. Appropriate and individualized orthosis is development direction of orthosis creation and design.