功能性电刺激、足踝矫形器对脑卒中后足下垂内翻患者即刻步行能力的影响

The immediate effect of functional electrical stimulation and ankle-foot orthosis on the walking abilities of post-stroke patients with foot drop and strephenopodia

目的:评价佩戴功能性电刺激(FES)、踝足矫形器(AFO)对脑卒中后足下垂内翻患者即刻步行能力的影响。方法:选取30例符合入组标准的脑卒中后足下垂内翻患者,依次佩戴FES、AFO及不佩戴辅具步行,3种状态下分别对患者进行10 m步速、功能性步行分级(FAC)评定。结果:佩戴AFO时的10 m舒适、快速步速均显著高于无支具时,差异有统计学意义;佩戴FES时的10 m舒适步速与无支具时相比无显著差异,10 m快速步速高于无支具时,但差异无统计学意义;佩戴AFO与佩戴FES时的10 m快速步速之间无显著差异;佩戴AFO和FES时的FAC分级皆显著高于无支具时,差异有统计学意义;佩戴AFO与佩戴FES时的FAC分级之间无显著差异。结论:佩戴FES、AFO均可以改善脑卒中后足下垂内翻患者即刻步行能力,AFO的即刻疗效优于FES。

Objective： To compare the immediate effect of functional electrical stimulation（FES） and ankle-foot orthosis（AFO） on the walking abilities of post-stroke patients with foot drop. Methods： Thirty post-stroke patients with foot drop and strephenopodia were enrolled according to the inclusion criteria. The 10 meter walk test（10 MWT） and functional ambulation category（FAC） were evaluated on each patient under 3 conditions： wearing FES, AFO or no assistant device. Results：Wearing AFO demonstrated statistically higher speed for both 10 meter comfort walk test and 10 meter rapid walk test compared with wearing no assistant device. While there were no significant differences between wearing FES and no assistant device in 10 MWT. For 10 meter comfort walk test, wearing AFO showed higher speed than wearing FES though no significant differences were detected. FAC grades when wearing AFO and FES were significantly higher than those without assistant device though their differences showed no statistical significance. Conclusion： Both wearing FES and AFO can improve the immediate walking abilities of post-stroke patients with foot drop and strephenopodia. At the beginning of wearing assistant devices, AFO has an immediate effect over FES.