半掌踝足矫形器与足跟镂空踝足矫形器对脑卒中患者步态影响的比较

The effects of a half palm ankle-foot orthosis and a hollow-heel ankle-foot orthosis on the gait of stroke survivors

目的观察半掌踝足矫形器和足跟镂空踝足矫形器对脑卒中患者步态的影响。方法选取符合标准的脑卒中患者25例,采用步态分析系统分别对25例脑卒中后步行功能障碍患者裸足、佩戴半掌踝足矫形器和佩戴足跟镂空踝足矫形器时的步行状态进行分析,记录三种状态下患者的步速、步频、健侧摆动相、患侧摆动相、跌倒风险和3 m起立计时行走时间,并进行统计学分析。结果受试者佩戴足跟镂空踝足矫形器时的步频为(86.718±17.947)Hz,较裸足和佩戴半掌踝足矫形器时均显著加快,差异均有统计学意义(P<0.05)。受试者佩戴足跟镂空踝足矫形器时的步态不对称系数为(0.086±0.070),与裸足时比较,差异有统计学意义(P<0.05)。受试者佩戴半掌踝足矫形器和佩戴足跟镂空踝足矫形器时的3 m起立计时行走时间较裸足时均显著缩短,差异均有统计学意义(P<0.05)。受试者佩戴半掌踝足矫形器和佩戴足跟镂空踝足矫形器时的跌倒风险均显著低于裸足时,差异均有统计学意义(P<0.05);且受试者佩戴足跟镂空踝足矫形器时的跌倒风险亦显著低于佩戴半掌踝足矫形器时,差异有统计学意义(P<0.05)。结论佩戴半掌踝足矫形器和足跟镂空踝足矫形器均可有效纠正脑卒中患者的步态,降低其跌倒风险,且佩戴足跟镂空踝足矫形器的优势更加明显。

Objective To observe any effect of a half palm ankle-foot orthosis and a hollow-heel ankle-foot orthosis on the gait of stroke survivors.Methods The walking of twenty-five stroke survivors was quantified using a gait analysis system.They walked barefoot,wearing a half palm ankle-foot orthosis and wearing a hollow-heel ankle-foot orthosis.Walking speed,step frequency,duration of the swing phase on the healthy and affected sides,risk of falling and Timed Up and Go(TUG)test times were recorded and analyzed.Results The average gait frequency when wearing the hollow-heel ankle-foot orthosis was significantly faster than that in the other two conditions.The gait asymmetry coefficient was significantly different when the subjects wore the hollow-heel ankle-foot orthosis compared with walking barefoot.Compared with being barefoot,the average TUG time was significantly shorter when wearing either orthosis and the risk of falling was significantly less.The fall risk was significantly lower when wearing the hollow-heel orthosis compared to the half palm orthosis.Conclusion Wearing either ankle-foot orthosis can significantly correct the gait of stroke survivors and lower their risk of falling,with better effect when wearing the hollow-heel ankle-foot orthosis.