动态踝足矫形器对脑卒中患者步行能力及平衡功能康复的影响

Effect of dynamic ankle-foot orthosis on rehabilitation of walking ability and balance function in stroke patients

目的探讨动态踝足矫形器对脑卒中引起足踝疾病的康复干预效果。方法选取60例脑卒中患者作为研究对象,随机分为治疗组(33例)和对照组(27例)。对照组采用康复训练,治疗组在康复训练基础上加用动态踝足矫形器,8周后对2组进行康复效果评估。采用Fugl-Meyer下肢运动功能评分(FMA)、10m步行试验(10MWT)和计时起立行走测试(TUG)评估步行能力。采用Berg平衡量表(BBS)、活动特定平衡信心量表(ABC)评估平衡功能。结果治疗前2组患者的FMA、10MWT、TUG、BBS、ABC评分比较差异均无统计学意义(P>0.05)。治疗后2组FMA、10MWT、TUG、BBS、ABC评分均优于治疗前,差异均有统计学意义(P<0.05)。与对照组比较,治疗组步行速度的进步幅度较小。结论动态踝足矫形器可有效改善脑卒中患者的步行和平衡能力,并能在8周内达到未使用动态踝足矫形器患者相同的功能增益。

Objective To investigate the effect of dynamic ankle and foot orthosis on rehabilitation of foot and ankle diseases caused by stroke.Methods Sixty patients with stroke were selected as study objects and randomly divided into the treatment group(33 cases)and the control group(27 cases).The control group received rehabilitation training,and the treatment group added dynamic ankle and foot orthosis on the basis of rehabilitation training.After 8 weeks,the two groups were evaluated for rehabilitation effect.The Fugl-Meyer lower extremity motor function score(FMA),10 m walking test(10 MWT),and timed standing walking test(TUG)were used to assess walking ability.The Berg Balance Scale(BBS)and Activity-Specific Balance Confidence Scale(ABC)were used to evaluate the balance function.Results There were no significant differences in FMA,10 MWT,TUG,BBS,and ABC scores between the two groups of patients before treatment(P>0.05).After treatment,the scores of FMA,10 MWT,TUG,BBS,and ABC were better than those before treatment,and the differences were statistically significant(P <0.05).Compared with the control group,the improvement of walking speed in the treatment group was smaller.Conclusion Dynamic ankle and foot orthosis can effectively improve the walking and balance ability of patients with stroke,and can achieve the same functional gain in patients without dynamic ankle and foot orthosis in 8 weeks.