踝足矫形器介入时机与脑卒中偏瘫病人步态的相关性研究

Study on the correlation between the timing of ankle-foot orthosis intervention and the gait of stroke patients with hemiplegia

目的探讨踝足矫形器(AFO)不同介入时机与脑卒中偏瘫病人步态的相关性。方法选择2018年7月至2020年1月期间潍坊医学院附属医院康复科脑卒中偏瘫住院病人共40例。其中A组为下肢Brunnstrom2期病人20例,B组为下肢Brunnstrom3期病人20例,两组均接受常规康复治疗和AFO治疗,两组病人均使用Senno Gait步态分析系统对其治疗前后进行步态分析。结果经过8个周的治疗后,两组病人的双支撑相比例均较治疗前变小;偏侧摆动相的比例均较治疗前变大;偏侧着地期内翻角均较治疗前变小;偏侧着地期背伸角均较治疗前变大;步宽治疗后均较治疗前变小。A、B两组相比较,A组病人的双支撑相治疗前后的差值(18.80±4.34)%显著大于B组病人的双支撑相治疗前后的差值(14.45±5.00)%,且A组的偏侧摆动相、偏侧着地期内翻角、偏侧着地期背伸角、步宽等指标治疗前后的差值也较B组病人大(P<0.05)。结论脑卒中偏瘫病人在Brunnstrom^(2)期介入AFO后步态各项指标优于Brunnstrom3期介入,因此AFO越早介入效果越好。

Objective To explore the correlation between different intervention timings of ankle-foot orthosis(AFO)and the gait of stroke patients with hemiplegia.Methods A total of 40 patients with stroke and hemiplegia in the Rehabilitation Department of Weifang Medical College Affiliated Hospital from July 2018 to January 2020 were selected.Group A includes 20 patients with lower limb Brunnstrom stage 2 and group B includes 20 patients with lower limb Brunnstrom stage 3.Both groups received conventional rehabilitation and AFO treatment,and both groups used Senno Gait gait analysis system to perform before and after treatment.Results After 8 weeks of treatment,the dual stance phase became smaller than that before treatment;the swing stance of the affected side became larger than that before treatment;the turning angle during the landing phase of the affected side became smaller than that before treatment;the dorsiflexion angle during the landing phase of the affected side became larger than that before treatment;the walking base became smaller than that before treatment.The difference of the dual stance phase before and after treatment in group A[(18.80±4.34)%]was significantly greater than that in group B patients[(14.45±5.00)%],and in group A the swing stance of the affected side,the angle of the affected side during landing,the dorsiflexion angle of the affected side during landing,and the walking base before and after treatment was also larger than those of group B(P<0.05).Conclusion The indicators of stroke patients with hemiplegia after Brunnstrom stage 2 AFO intervention are better than Brunnstrom stage 3 intervention,so the earlier AFO intervention,the better the effect.