可调节踝足矫形器配合针灸对脑出血偏瘫患者足畸形及步行能力的影响

Effect of adjustable ankle-foot orthosis combined with acupuncture on foot deformity and walking ability of hemiplegic patients with cerebral hemorrhage

目的:探讨可调节踝足矫形器配合针灸治疗在脑出血偏瘫患者足畸形及步行能力改善方面的影响。方法:86例脑出血偏瘫患者随机分为观察组和对照组各43例。对照组在常规治疗基础上配合针灸治疗,观察组在对照组基础上配戴可调节踝足矫形器。治疗6周后统计足下垂及足内翻畸形率,治疗前后采用Berg平衡量表(BBS)、改良Barthel指数(MBI)和Holden功能步行分级(FAC)进行评定。结果:治疗6周后,观察组患者足下垂或足内翻畸形较对照组明显减少(P<0.05)。治疗后,2组患者BBS及MBI评分均较治疗前明显提高(均P<0.05),且观察组明显高于对照组(均P<0.05)。治疗后,2组患者FAC分级均较治疗前明显提高(均P<0.05),且观察组FAC分级明显优于对照组(P<0.05)。结论:可调节踝足矫形器配合针灸治疗可有效减少脑出血偏瘫患者的足下垂和足内翻畸形,改善平衡能力、步行功能和提高日常生活活动能力。

Objective: To investigate the effect of adjustable ankle-foot orthotics combined with acupuncture on the improvement of foot deformity and walking ability in hemiplegic patients with cerebral hemorrhage. Methods: Eighty six patients with hemiplegia after cerebral hemorrhage were randomly divided into observation group ( n =43) and control group ( n =43). The control group and the observation group were treated with acupuncture on the basis of conventional treatment,and the observation group was equipped with an adjustable ankle-foot orthosis. After 6 weeks of treatment,the rates of foot drop and varus deformity were counted. Before and after treatment,Berg Balance Scale (BBS),Modified Barthel Index (MBI) and Holden Functional Walking Grading (FAC) were used for evaluation. Results: After 6 weeks of treatment,the foot drop or foot varus deformity in the observation group was significantly reduced ( P < 0.05 ),and BBS and MBI scores were significantly increased as compared with those in the control group ( P < 0.05 ). The FAC was significantly better in the observation group than in the control group ( P < 0.05 ). Conclusion: Adjustable ankle-foot orthosis combined with acupuncture treatment can effectively reduce the foot drop and foot varus deformity in patients with cerebral hemorrhage and hemiplegia,improve the balance ability,walking function and activity of daily life.