矫形弹力绷带对痉挛性偏瘫脑性瘫痪患儿步态对称性和步行能力的效果

Effect of orthopedic elastic bandages on gait symmetry and walking ability in children with spastic hemiplegic cerebral palsy

目的观察矫形弹力绷带改善痉挛性偏瘫脑瘫患儿步态对称性和步行能力的短期疗效。方法2020年6月至2023年6月,北京博爱医院痉挛性偏瘫脑瘫患儿31例,随机分为对照组(n=15)和试验组(n=16)。两组均接受常规康复治疗,此外,对照组采用常规步行训练,试验组佩戴矫形弹力绷带进行步行训练,共4周。训练前后,计算足偏角比(患侧足偏角/健侧足偏角)、步长比(患侧步长/健侧步长)、步态线长比(患侧步态线长/健侧步态线长)和站立阶段比(患侧站立阶段百分比/健侧站立阶段百分比);测量步宽和10米步行测试(10MWT)速度。结果试验组脱落1例。训练后,两组足偏角比、步长比、步态线长比和站立阶段比均改善(|t|>2.434,P<0.05),且试验组优于对照组(|t|>2.230,P<0.05);两组10MWT自选速度和最大速度均显著提高(|t|>9.186,P<0.001),且试验组高于对照组(|t|>2.278,P<0.05)。结论佩戴矫形弹力绷带训练能有效改善痉挛性偏瘫脑瘫患儿的步态对称性和步行能力。

Objective To investigate the short-term efficacy of orthopedic elastic bandages on gait symmetry and walking ability in children with spastic hemiplegic cerebral palsy.Methods From June,2020 to June,2023,31 children with spastic hemiplegic cerebral palsy from Beijing Bo'ai Hospital were randomly divided into control group(n=15)and experimental group(n=16).Both groups received rou‐tine rehabilitation,while the control group received routine walking training,and the experimental group wore an orthopedic elastic bandage for walking training,for four weeks.The indexes of gait symmetry of foot deviation angle ratio(affected/healthy),step length ratio(affected/healthy),gait line ratio(affected/healthy)and standing stage ratio(affected percentage/healthy percentage)were calculated before and after training,and they were mea‐sured step width and the optional and maximum walking speed of 10-meter walk test(10MWT).Results One case dropped off in the experimental group.After training,the foot deviation ratio,step length ratio,gait line ratio,and standing stage ratio improved in both groups(|t|>2.434,P<0.05),and they were better in the experimental group than in the control group(|t|>2.230,P<0.05);while the optional and maximum walking speed of 10MWT improved in both groups(|t|>9.186,P<0.001),and they were better in the experimental group than in the control group(|t|>2.278,P<0.05).Conclusion Wearing orthopedic elastic bandages during rehabilitation can promote the gait symmetry and walking abili‐ty of children with spastic hemiplegic cerebral palsy.