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Presentation and management outcome of foot drop with tibialis posterior tendon transfer
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作者 Muhammad Saaiq 《World Journal of Orthopedics》 2024年第11期1047-1055,共9页
BACKGROUND Foot drop causes considerable disability.The ankle-dorsiflexion is either weak or lost completely.Additionally,the ankle eversion and toe extensions are also impaired.This results in a high steppage gait wh... BACKGROUND Foot drop causes considerable disability.The ankle-dorsiflexion is either weak or lost completely.Additionally,the ankle eversion and toe extensions are also impaired.This results in a high steppage gait while walking.Overall,the gait is awkward;there is greater energy consumption;increased proneness to sustain injury of the forefoot;and more frequent falling during walking.AIM To document the clinical and epidemiological profile of foot drop patients in our population and evaluate the outcome of tibialis posterior(TP)tendon transfer for restoring the lost dorsiflexion in foot drop.METHODS The study was carried out at the National Institute of Rehabilitation Medicine in Islamabad over a period of 7 years.It included patients of all sexes and ages who presented with foot drop and had no contraindications for the procedure of TP tendon transfer.Exclusion criteria were patients who had contraindications for the operation.For instance,paralyzed posterior leg compartment muscles,Achilles tendon contracture,stiff ankle or toes,unstable ankle joint,weak gastrocnemius and scarred skin spanning over the route of planned tendon transfer.Also,patients who had the foot drop as a result of disc prolapses or brain diseases were excluded.Convenience sampling technique was used.The circum-tibial route of TP tendon transfer was employed.RESULTS Out of 37 patients,26(70.27%)were males whereas 11(29.72%)were females.The mean age was 22.59±8.19 years.Among the underlying causes of foot drop,road traffic accidents constituted the most common cause,found among 20(54.05%)patients.The share of complications included wound infections in 3(8.10%)patients and hypertrophic scars in 2(5.40%)patients.At 1-year postoperative follow-up visits,the outcome was excellent in 8(21.62%),good in 20(54.05%)and moderate in 9(24.31%).CONCLUSION The majority of cases of foot drop resulted from road traffic accidents that directly involved the common peroneal nerve.TP tendon transfer through the circumtibial route was found to be an easily executed effective operation which restored good dorsiflexion of the ankle among the majority of patients. 展开更多
关键词 foot drop Common peroneal nerve Peroneal nerve palsy Tibialis posterior transfer Tibialis anterior Tendon transfer
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Differential diagnosis and treatment of foot drop caused by an extraneural ganglion cyst above the knee:A case report
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作者 Ki Hong Won Eun Young Kang 《World Journal of Clinical Cases》 SCIE 2022年第21期7539-7544,共6页
BACKGROUND One of the causes of foot drop is compression of the common peroneal nerve caused by space-occupying lesions such as a synovial cyst or a ganglion cyst.Most previous reports have involved compressive common... BACKGROUND One of the causes of foot drop is compression of the common peroneal nerve caused by space-occupying lesions such as a synovial cyst or a ganglion cyst.Most previous reports have involved compressive common peroneal neuropathy by intraneural ganglion cysts and synovial cysts.Compression of the peroneal nerve by extraneural ganglion cysts is rare.We report a rare case of compressive common peroneal neuropathy by an extraneural ganglion cyst.CASE SUMMARY A 46-year-old man was hospitalized after he reported a right foot drop for 1 mo.Manual muscle testing revealed scores of 1/5 on dorsiflexion of the right ankle.Hypoesthesia and paresthesia on the right lateral leg and foot dorsum were noted.He was diagnosed with a popliteal cyst by using electrophysiologic study and popliteal ultrasound(US).To facilitate common peroneal nerve(CPN)decompression,2 cc of sticky gelatinous material was aspirated from the cyst under US guidance.Electrical stimulation and passive and assisted active ROM exercises of the right ankle and strengthening exercises for weak muscles using elastic band were prescribed based on the change of muscle power.A posterior leaf spring ankle-foot orthosis was prescribed to assist the weak dorsiflexion of the ankle.Follow-up US revealed that the cystic lesion was growing and magnetic resonance imaging demonstrated compression of the CPN by the cystic mass.The cyst was resected to prevent impending compression of the CPN.CONCLUSION Precise diagnosis and immediate treatment are important in cases of compressive common peroneal neuropathy caused by an extraneural cyst. 展开更多
关键词 foot drop Extranueral ganglion cyst Common peroneal neuropathy Popliteal ultrasound Electrodiagnostic study CYSTECTOMY Case report
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The mechanism and clinical effectiveness of the six-step Chinese Daoyin technique on hemiplegic patients with drop-foot
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作者 Wen-Ru Zhao Hai-Hong Zhao +2 位作者 Xue-Min Zhang Xiao Cao Xin Li 《Journal of Biomedical Science and Engineering》 2012年第11期652-656,共5页
Objective: The aim of this study was to improve the Chinese Daoyin technique (physical and breathing exercises), which is an ancient rehabilitation method, to elevate its effect and to standardize its operational proc... Objective: The aim of this study was to improve the Chinese Daoyin technique (physical and breathing exercises), which is an ancient rehabilitation method, to elevate its effect and to standardize its operational procedure. Methods: Based on the ancient Chinese Daoyin technique, a six-step method was developed including: 1) motion imagination and imitation;2) mental and breathing regulation;3) target point determination;4) motion percussion;5) motion persistence;6) relaxation. Sixty drop-foot patients who suffered from hemiparesis after a stroke were randomly divided into the experimental group and the control group. Functional evaluation including Fugl-Meyer assessment score, Lovett manual muscle test (MMT), active range of motion of the ankle joint and electromyography were performed before and after the training course. The data were analyzed using the statistical software SPSS 12.0. Results: The differences between the two groups were significant. The effectiveness of the six-step group was significantly better than the effectiveness of the control group. Conclusion: The six-step method of the Chinese Daoyin technique is an effective rehabilitation training method for drop-foot in stroke patients with hemiparesis. 展开更多
关键词 Rehabilitation CHINESE DAOYIN Technique Six-Step Method Hemiparesis drop-foot
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Development of an Index for Drop-Foot Severity of DPN Patients
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作者 Albert K. Chong Suhad K. R. Al-Magsoosi 《Journal of Biosciences and Medicines》 2019年第5期61-64,共4页
Currently, the population percentage of diabetics suffering Diabetic Peripheral Neuropathy (DPN) and foot-drop gait anomaly was estimates as 15% in the United States. The onset of foot-drop could not be detected until... Currently, the population percentage of diabetics suffering Diabetic Peripheral Neuropathy (DPN) and foot-drop gait anomaly was estimates as 15% in the United States. The onset of foot-drop could not be detected until symptoms could be observed visually, patient falling or patient experiencing painful gait issues and expensive medical tests. This research showed that by utilizing the plantar-pressure characteristics of DPN drop-foot gait, a set of index could be developed for the severity of DPN. 展开更多
关键词 PLANTAR Pressure Sensor Gait foot-drop DPN DIABETIC INDEX
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Tendon Transfer for Foot Drop: A Simple Procedure with Effective Outcome Local Experience
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作者 Hesham El Sobky Nabil Ali Amr Farid Khalil 《Open Journal of Modern Neurosurgery》 2019年第3期258-268,共11页
Introduction:?Patients presented with old neglected common peroneal nerve injuries, failed 2ry repair, compression neuropathies not improved after decompression and closed injuries with no improvement on conservative ... Introduction:?Patients presented with old neglected common peroneal nerve injuries, failed 2ry repair, compression neuropathies not improved after decompression and closed injuries with no improvement on conservative measures which are still unsolved problems. Poor recovery of this nerve after repair or decompression gives great importance to tendon transfer in these situations. Material and Methods: This study was conducted in Neurosurgery Department of Mansoura University from 2015 to 2018 on twenty-six patients (16 males and 10 females). Their age ranged from 6 - 58 years. All of them presented with persistent foot drop at least for one year after injury with no signs of improvement clinically or in electrophysiological studies. All patients underwent tibialis posterior tendon transfer through the interosseous membrane to the tendons of the leg anterior compartment. All of them were put in a plaster cast for four weeks postoperative. A physiotherapeutic program was applied for all patients as preoperative preparation and postoperative rehabilitation. Results: Twenty-two patients showed satisfactory results, three patients fair improvement and one patient no improvement. Two patients had wound infection and there was no mortality in this study. Conclusion:?Tendon transfer is an effective valid solution to be considered in the management of foot drop in these patients. 展开更多
关键词 foot drop Tibialis POSTERIOR TRANSFER
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Effects of a Cordura Material Ankle-Foot Orthosis on Balance Performance in Patients with Foot Drop
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作者 唐智 仇裕翔 +3 位作者 康国芳 汪丽娜 周韵雯 刘志辉 《Journal of Donghua University(English Edition)》 EI CAS 2016年第4期583-586,共4页
As one of the clinical manifestations in patients with hemiplegia after stroke,most of the patients with foot drop suffer from gait disturbance and balance dysfunction, generally accompanied by strephenopodia. There a... As one of the clinical manifestations in patients with hemiplegia after stroke,most of the patients with foot drop suffer from gait disturbance and balance dysfunction, generally accompanied by strephenopodia. There are relatively few researches on the balance ability of patients with foot drop worldwide,while the balance ability will directly affect the walking ability for recovery,so the research is significant in the rehabilitation of foot drop. In the experiment,the Cordura material ankle-foot orthosis (AFO),one of the world leading technology products,is chosen as the experimental equipment because of its well-known durability and strength. The experiment studied the balance performance of patients with foot drop before and after wearing Cordura material AFO. The Berg scale was evaluated to discuss the effect of the orthosis on balance ability in patients with foot drop. It has been found that the wearing equipment BBS scores were significantly improved. There were significant differences comparing with the control group( P&lt;0.05).But in the course of treatment the Berg balance scale (BBS) scores reduced individually,mainly in terms of leg flexibility. 展开更多
关键词 disturbance durability suffer rehabilitation walking chosen accompanied correct formulated flexibility
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Observation of the Effect of Gait-induced Functional Electrical Stimulation on Stroke Patients with Foot Drop
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作者 Anqi Zhang Mengjiao Wu +3 位作者 Luxi Mao Qianhuan Zhang Bingqian Zhou Jingxin Wang 《Journal of Advances in Medicine Science》 2022年第1期12-18,共7页
Objective:To explore the effects of functional electrical stimulation and functional mid frequency electrical stimulation on lower limb function and balance function in stroke patients.Methods:20 cases of stroke patie... Objective:To explore the effects of functional electrical stimulation and functional mid frequency electrical stimulation on lower limb function and balance function in stroke patients.Methods:20 cases of stroke patients with foot drop after admission were randomly divided into the observation group and the control group,10 cases in each group.On the basis of the two groups of patients,the observation group used the gait induced functional electrical stimulation to stimulate the peroneal nerve and the pretibial muscle in the observation group.The control group used the computer medium frequency functional electrical stimulation to stimulate the peroneal nerve and the anterior tibial muscle for 2 weeks.Before and after treatment,the lower extremity simple Fugl-Meyer scale(FMA),the Berg balance scale(BBS)and the improved Ashworth scale were evaluated respectively,and the comparative analysis was carried out in the group and between the groups.Results:After 2 weeks of treatment,the scores of FMA and BBS in the two groups were significantly higher than those before the treatment(P<0.05),and the scores of FMA and BBS in the observation group were higher than those in the control group(P<0.05),and the flexor muscle tension of the ankle plantar flexor muscle of the observed group was lower than that of the control group(P<0.05).Conclusions:Exercise therapy combined with gait induced functional electrical stimulation or computer intermediate frequency functional electrical stimulation can significantly improve lower limb function and balance function in patients with ptosis,and the therapeutic effect of functional electrical stimulation combined with gait is better. 展开更多
关键词 foot drop Functional electrical stimulation Lower limb function Balance function
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脑卒中后足下垂相关研究的文献计量分析 被引量:1
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作者 李艳丽 刘兰群 +1 位作者 徐基民 王海芳 《中国康复理论与实践》 CSCD 北大核心 2024年第6期686-692,共7页
目的 分析脑卒中后足下垂领域内的研究动态和前沿趋势。方法 检索建库至2024年1月Web of Science Core Collection数据库中脑卒中后足下垂的相关文献,采用CiteSpace 6.2.R2和VOSviewer 1.6.19进行可视化分析。结果 共检索到490篇文献。1... 目的 分析脑卒中后足下垂领域内的研究动态和前沿趋势。方法 检索建库至2024年1月Web of Science Core Collection数据库中脑卒中后足下垂的相关文献,采用CiteSpace 6.2.R2和VOSviewer 1.6.19进行可视化分析。结果 共检索到490篇文献。1992年以后发文量逐年增加,2020年最多。研究机构以美国的机构为主。文献聚焦于医学、医疗和临床领域,康复学文献最多,达到230篇。高频率关键词有康复、偏瘫步态、电刺激、足下垂和脑卒中等。通过关键词共现分析,形成关于运动康复、神经康复技术、步态分析、功能性恢复技术、康复治疗效果评估等10个主要聚类。结论 脑卒中后足下垂的康复研究正朝着技术与治疗方法相融合、注重运动功能评估和治疗效果证据,以及个体化康复方案的方向发展。 展开更多
关键词 脑卒中 足下垂 知识图谱 文献计量学
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脑卒中卧床患者足部压力性损伤预防装置的设计与应用
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作者 杨湘英 郑越 +2 位作者 张茜 林沛钰 宁丽 《中国中西医结合急救杂志》 CAS CSCD 2024年第2期193-197,共5页
目的观察脑卒中卧床患者足部压力性损伤预防装置的临床应用效果。方法选择2021年3月至2022年3月在杭州市第一人民医院重症监护病房(ICU)住院的(166例)脑卒中患者作为研究对象。采用定量研究中的实验设计,根据病区将患者分为对照组(ICU ... 目的观察脑卒中卧床患者足部压力性损伤预防装置的临床应用效果。方法选择2021年3月至2022年3月在杭州市第一人民医院重症监护病房(ICU)住院的(166例)脑卒中患者作为研究对象。采用定量研究中的实验设计,根据病区将患者分为对照组(ICU 4楼患者)和观察组(ICU 5楼患者),每组83例;护士也按照此法分组(观察组41名,对照组43名)。两组均进行常规治疗及预防压力性损伤护理,对照组采用海绵圈或现有的枕头减压,并采用丁字鞋内衬毛巾预防足下垂,观察组采用自行设计研发的卧床患者足部压力性损伤预防装置。观察两组患者足部压力性损伤和足下垂的发生率,以及患者使用足部压力性损伤预防装置的满意度和护士操作足部压力性损伤预防装置的满意度。结果观察组足部压力性损伤和足下垂发生率均明显低于对照组〔足部压力性损伤:3.61%(3/83)比8.43%(7/83);足下垂发生率:9.64%(8/83)比16.87%(14/83),均P<0.05〕;观察组患者满意度明显高于对照组〔91.6%(76/83)比79.5%(66/83),P<0.05〕;护士满意度较对照组升高〔95.1%(39/41)比86.0%(37/43)〕,但差异无统计学意义(P>0.05)。结论足部压力性损伤预防装置适用于脑卒中重症卧床患者,可有效地降低压力性损伤及足下垂的发生率,提高患者和操作人员的满意度,值得在临床上推广使用。 展开更多
关键词 脑卒中 卧床患者 压力性损伤 足下垂 预防
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基于步态事件和sEMG的功能性电刺激起始点研究
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作者 邓昌仁 陈恩伟 +1 位作者 张佳峰 王勇 《合肥工业大学学报(自然科学版)》 CAS 北大核心 2024年第5期590-595,共6页
足下垂患者步行过程中进行功能性电刺激可以帮助其恢复正常行走能力,而准确确定功能性电刺激的开启时间至关重要。文章针对该问题,利用步行过程中下肢的角速度和表面肌电信号(surface electromyography,sEMG),提出一种以步态事件与肌肉... 足下垂患者步行过程中进行功能性电刺激可以帮助其恢复正常行走能力,而准确确定功能性电刺激的开启时间至关重要。文章针对该问题,利用步行过程中下肢的角速度和表面肌电信号(surface electromyography,sEMG),提出一种以步态事件与肌肉动作点之间延时关系为控制策略的足下垂步行过程中功能性电刺激准确开启的方法。根据步态信息和sEMG电信号特征对大腿处的角速度数据进行步态事件划分,试验结果表明步态事件划分得具有良好一致性;利用模糊熵算法对去噪后的sEMG信号进行肌肉运动起始点T muscle的判定,确定T muscle与脚尖离地(toe off,TO)之间的延时时间关系;结合所划分的步态事件特征点,确定电刺激起始点T on。该文为足下垂治疗中功能性电刺激开启时间点的确定提供了一种新的辨识方法。 展开更多
关键词 步态分析 表面肌电信号(sEMG) 模糊熵 功能性电刺激起始点 足下垂
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针灸联合肌电生物反馈对脑卒中足下垂患者身体平衡功能、步行能力及日常生活活动能力的影响
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作者 马标 鲍文 程密密 《四川中医》 2024年第3期184-187,共4页
目的:探讨针灸联合肌电生物反馈对脑卒中足下垂患者身体平衡功能、步行能力及日常生活活动能力的影响。方法:回顾性选取2022年1月到2023年7月合肥市第一人民医院神经内科和康复科收治的100例脑卒中足下垂患者作为研究对象,按照治疗方法... 目的:探讨针灸联合肌电生物反馈对脑卒中足下垂患者身体平衡功能、步行能力及日常生活活动能力的影响。方法:回顾性选取2022年1月到2023年7月合肥市第一人民医院神经内科和康复科收治的100例脑卒中足下垂患者作为研究对象,按照治疗方法分为肌电生物反馈组(47例)和联合组(53例,针灸联合肌电生物反馈),比较两组痉挛程度[采用临床痉挛指数(CSI)评估]、身体平衡功能[采用Berg平衡量表(BBS)评估]、踝关节活动度(ROM)[主动背伸度、主动跖屈度、主动内翻度]、血液流变学指标[血浆粘度(PV)、血小板聚集率(PAR)、红细胞比容(Hct)]、步行能力[步频、步幅、患侧摆动相、患侧支持相]和日常生活活动能力[采用改良Barthel指数(MBI)评估]。结果:治疗后,联合组CSI评分低于肌电生物反馈组,BBS评分高于肌电生物反馈组(P<0.05);治疗后,联合组主动背伸度高于肌电生物反馈组,主动跖屈度、主动内翻度低于肌电生物反馈组(P<0.05);治疗后,联合组PV、PAR、Hct水平低于肌电生物反馈组(P<0.05);治疗后,联合组步频、步幅、患侧摆动相、患侧支持相水平高于肌电生物反馈组(P<0.05);治疗后,联合组MBI评分高于肌电生物反馈组(P<0.05)。结论:针灸联合肌电生物反馈治疗脑卒中足下垂患者的效果显著,可有效改善痉挛程度、身体平衡功能、踝关节ROM以及血流循环,提高步行能力以及日常生活能力。. 展开更多
关键词 脑卒中足下垂 针灸 肌电生物反馈 身体平衡功能 步行能力
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重复经颅磁刺激联合康复训练在卒中后偏瘫足下垂患者中的应用效果
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作者 李晓 《中国民康医学》 2024年第3期107-109,113,共4页
目的:观察重复经颅磁刺激联合康复训练在卒中后偏瘫足下垂患者中的应用效果。方法:选取2020年1月至2023年4月该院收治的94例卒中后偏瘫足下垂患者进行前瞻性研究,按照随机数字表法将其分为对照组和研究组各47例。对照组给予康复训练,研... 目的:观察重复经颅磁刺激联合康复训练在卒中后偏瘫足下垂患者中的应用效果。方法:选取2020年1月至2023年4月该院收治的94例卒中后偏瘫足下垂患者进行前瞻性研究,按照随机数字表法将其分为对照组和研究组各47例。对照组给予康复训练,研究组在对照组基础上联合重复经颅磁刺激治疗,比较两组临床疗效、治疗前后步行功能[Fugl-Meyer运动功能量表(FMA)、功能性步行量表(FAC)]评分、步态参数(步频、步速、步幅、步宽)水平和康复满意度。结果:研究组治疗总有效率为76.60%(36/47),高于对照组的51.06%(24/47),差异有统计学意义(P<0.05);治疗后,研究组FMA、FAC评分均高于对照组,差异有统计学意义(P<0.05);研究组步频、步速、步幅、步宽均高于对照组,差异有统计学意义(P<0.05);研究组康复满意度为87.23%(41/47),高于对照组的68.09%(32/47),差异有统计学意义(P<0.05)。结论:重复经颅磁刺激联合康复训练应用于卒中后偏瘫足下垂患者可提高治疗总有效率、步行功能评分、步态参数水平和康复满意度,效果优于单纯康复训练。 展开更多
关键词 重复经颅磁刺激 康复训练 卒中 偏瘫 足下垂 步行功能 满意度
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踝关节动态松动术改善脑卒中患者足下垂的效果
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作者 闫鹏程 胡小红 +1 位作者 曹昱 韦玲 《反射疗法与康复医学》 2024年第6期85-87,91,共4页
目的探讨踝关节动态关节松动术应用于脑卒中后足下垂患者中的效果.方法选取2020年6月—2021年6月就诊于山西省针灸医院康复科的70例脑卒中后足下垂患者为研究对象,采用随机数字表法将其分为研究组和对照组,每组35例.对照组采用常规康复... 目的探讨踝关节动态关节松动术应用于脑卒中后足下垂患者中的效果.方法选取2020年6月—2021年6月就诊于山西省针灸医院康复科的70例脑卒中后足下垂患者为研究对象,采用随机数字表法将其分为研究组和对照组,每组35例.对照组采用常规康复治疗,研究组在此基础上采用踝关节动态关节松动术,比较两组患者的干预效果.结果治疗前,两组的踝关节主动背屈关节活动度比较,差异无统计学意义(P>0.05);治疗后,研究组的踝关节主动背屈关节活动度为(12.64±4.01)°,大于对照组的(9.93±3.22)°,差异有统计学意义(P<0.05).治疗前,两组的主动踝背屈肌力和闭目站立得分比较,组间差异无统计学意义(P>0.05);治疗后,研究组的主动踝背屈肌力为(4.07±1.75)级,闭目站立得分为(3.67±1.94)分,均高于对照组的(2.74±1.32)级、(2.93±1.52)分,组间差异有统计学意义(P<0.05).结论踝关节动态关节松动术能有效增加脑卒中足下垂患者的踝关节主动活动度,改善其踝背屈肌力,并提高其闭目站立平衡功能,值得临床推广使用. 展开更多
关键词 脑卒中 足下垂 踝关节动态关节松动术
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Therapeutic efficacy and safety of various botulinum toxin A doses and concentrations in spastic foot after stroke: a randomized controlled trial 被引量:7
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作者 Jiang Li Ru Zhang +4 位作者 Bo-li Cui Yong-xiang Zhang Guang-tao Bai Si-shan Gao Wen-jian Li 《Neural Regeneration Research》 SCIE CAS CSCD 2017年第9期1451-1457,共7页
No recommended guidelines currently exist for the therapeutic concentration or dose of botulinum toxin type A (BTXA) injected into the muscle to treat limb spasticity. Therefore, in this randomized controlled trial,... No recommended guidelines currently exist for the therapeutic concentration or dose of botulinum toxin type A (BTXA) injected into the muscle to treat limb spasticity. Therefore, in this randomized controlled trial, we explored the safety and efficacy of two concentrations and two doses of BTXA in the treatment of spastic toot after stroke to optimize this treatment in these patients. Eligible patients (n = 104) were randomized into four groups. The triceps surae and tibialis posterior on the affected side were injected with BTXA at one of two doses (200 U or 400 U) and two concentrations (50 U/mL or 100 U/mL). 2he following assessments were conducted before as well as 4 days and 1, 2, 4, and 12 weeks after treatment: spasticity, assessed using the modified Ashworth scale; basic functional mobility, assessed using a timed up and go test; pace, assessed using a 10-meter timed walking test; and the ability to walk, assessed using Holden's graded scale and a visual analog scale. The reported results are based on the 89 patients that completed the study. We found significant differences for the two doses and concentrations of BTXA to improve the ability of patients to walk independently, with the high-dose/low-concentration combination providing the best effect. Onset and duration of the ameliorating effects of BTXA were 4-7 days and 12 weeks, respectively. Thus, BTXA effectively treated foot spasms after stroke at an optimal dose of 400 U and concentration of 50 U/mL. 展开更多
关键词 nerve regeneration STROKE Jbot spasms botulinum toxin type A foot varus foot drop walking function neural regeneration
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踝关节虚拟现实训练对脑卒中患者足下垂和步行功能的影响
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作者 王路 杜志伟 +3 位作者 陈艳 于瑞 曾一鸣 余绵绚 《按摩与康复医学》 2023年第9期14-17,共4页
目的:观察踝关节虚拟现实训练对脑卒中患者足下垂和步行功能的影响。方法:选取60例脑卒中患者按随机数字表法分为对照组(n=30)和治疗组(n=30),对照组在常规康复训练上增加普通踝关节训练,治疗组在常规康复训练上增加踝关节虚拟现实训练... 目的:观察踝关节虚拟现实训练对脑卒中患者足下垂和步行功能的影响。方法:选取60例脑卒中患者按随机数字表法分为对照组(n=30)和治疗组(n=30),对照组在常规康复训练上增加普通踝关节训练,治疗组在常规康复训练上增加踝关节虚拟现实训练,治疗前后采用踝关节主动活动度(AROM)、Fugl-Meyer下肢运动功能量表(Fugl-Meyer assessment lower extremity,FMA-LE)、10m最大步行速度(10m maximum walking speed,MWS)、计时起立-行走测试(timed up and go test,TUGT)进行评估。结果:治疗4周后,两组患者踝关节主动活动度AROM、FMA-LE评分、TUGT时间、10mMWS均较治疗前显著改善(P<0.05),且治疗组各项指标均优于对照组,差异有统计学意义(P<0.05)。结论:踝关节虚拟现实训练可显著改善脑卒中患者的足下垂和步行功能。 展开更多
关键词 脑卒中 虚拟现实 足下垂 步行功能
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针刺联合肌电生物反馈疗法治疗脑卒中偏瘫患者足下垂的临床研究 被引量:7
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作者 卢燕 童心 +3 位作者 杨春花 李琳 叶培结 徐磊 《中国康复》 2023年第2期73-77,共5页
目的:探讨针刺联合肌电生物反馈疗法治疗脑卒中偏瘫患者足下垂的效果。方法:选取90例恢复期脑卒中偏瘫足下垂患者,按随机数字表法分为针刺治疗组、肌电生物反馈治疗组、联合治疗组,每组患者30例。针刺治疗组进行针刺治疗,肌电生物反馈... 目的:探讨针刺联合肌电生物反馈疗法治疗脑卒中偏瘫患者足下垂的效果。方法:选取90例恢复期脑卒中偏瘫足下垂患者,按随机数字表法分为针刺治疗组、肌电生物反馈治疗组、联合治疗组,每组患者30例。针刺治疗组进行针刺治疗,肌电生物反馈治疗组进行肌电生物反馈治疗,联合治疗组进行针刺联合肌电生物反馈治疗。治疗前及治疗4周后分别采用踝关节背屈主动关节活动度(AROM)、下肢Fugl-Meyer运动功能量表(FMA-LE)、Berg平衡量表(BBS)及改良Barthel指数(MBI)分别评估患者的踝关节背屈能力、下肢运动功能、平衡功能及日常生活活动能力,并对3组患者的胫前肌和腓骨长短肌进行表面肌电图(iEMG)检测。结果:治疗4周后,3组患者的踝关节背屈AROM、下肢FMA评分、BBS评分、MBI、iEMG、均方根值(RMS)均较治疗前明显提高(P<0.05);治疗4周后组间比较,联合治疗组的各评分值改善程度均优于针刺组和肌电生物反馈治疗组(P<0.05);针刺组与肌电生物反馈治疗组的各评分值差异无统计学意义。结论:针刺联合肌电生物反馈疗法能显著改善脑卒中偏瘫患者的足下垂。 展开更多
关键词 脑卒中 针刺 肌电生物反馈疗法 足下垂
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短足训练对扁平足患者足踝功能影响的Meta分析与系统评价 被引量:1
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作者 冯亮 龚树辉 霍洪峰 《中国组织工程研究》 CAS 北大核心 2023年第5期799-804,共6页
目的:运用Meta分析方法综合定量评价短足训练对扁平足患者足踝功能的影响,为扁平足患者更有效地进行训练提供理论依据。方法:检索Web of Science、The Cochrane Library、PubMed、Embase、CNKI数据库、维普数据库、中国生物医学文献数... 目的:运用Meta分析方法综合定量评价短足训练对扁平足患者足踝功能的影响,为扁平足患者更有效地进行训练提供理论依据。方法:检索Web of Science、The Cochrane Library、PubMed、Embase、CNKI数据库、维普数据库、中国生物医学文献数据库等中外文献数据库。检索文献时限为各数据库建库至2022-01-31。中文数据库检索词与检索式:(扁平足OR外翻足OR硬足)AND(短足训练OR物理治疗);英文数据库检索词与检索式(flat foot OR talipes valgus OR talipes calcaneovalgus)AND(short foot exercises OR physical therapy OR neurophysiotherapy)。选用Cochrane偏倚风险评估工具对纳入文献进行质量评价,运用Revman 5.4和Stata 12.0软件对所有纳入文献的足舟下降高度、足姿指数进行分析。结果:共纳入12篇文献,443名受试者。5篇为中度偏倚风险文献、7篇为低度偏倚风险文献。短足训练具有降低足舟下降高度的效果(SMD=-0.59,P<0.05)。受试者年龄(回归系数:-1.5639,P=0.004)、体质量指数(回归系数:-1.5639,P=0.023)和干预时间(回归系数:-1.4456,P=0.042)影响了纳入文献的整体效应。从效应量上来看,短足训练对足姿指数的干预有效果,但差异无显著性意义(SMD=-0.26,P>0.05)。结论:短足训练可以有效降低扁平足患者的足舟下降高度,对足姿指数的影响尚不明确。年龄、体质量指数和干预时间是影响短足训练干预效果的因素,是展开相关研究和组织扁平足患者康复训练需要考虑的因素。推荐扁平足患者选择短足训练作为训练手段。 展开更多
关键词 短足训练 扁平足 META分析 足舟下降高度 足姿指数
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功能性电刺激联合肌筋膜疼痛触发点针刺疗法对脑卒中后痉挛型足下垂患者步态稳定性及FAC评分的影响 被引量:3
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作者 韩春节 刘继红 +2 位作者 张玲俐 唐爱群 童燕娜 《临床和实验医学杂志》 2023年第12期1270-1273,共4页
目的研究功能性电刺激联合肌筋膜疼痛触发点针刺疗法对脑卒中后痉挛型足下垂患者步态稳定性及功能性步行量表(FAC)评分的影响。方法前瞻性选取2019年4月至2022年10月首都医科大学附属北京潞河医院收治的116例脑卒中后痉挛型足下垂患者... 目的研究功能性电刺激联合肌筋膜疼痛触发点针刺疗法对脑卒中后痉挛型足下垂患者步态稳定性及功能性步行量表(FAC)评分的影响。方法前瞻性选取2019年4月至2022年10月首都医科大学附属北京潞河医院收治的116例脑卒中后痉挛型足下垂患者作为研究对象。按随机数字表法将其分为两组,每组58例。对照组采用功能性电刺激治疗,观察组采用功能性电刺激联合肌筋膜疼痛触发点针刺疗法治疗。统计分析两组治疗前后步态时空参数、FAC评分及临床痉挛指数(CSI)评分。结果治疗后,两组步频、步幅、患侧支持相及患侧摆动相均较治疗前明显升高,且观察组步频、步幅、患侧支持相及患侧摆动相分别为(1.24±0.06)步/s、(0.45±0.04)m、(0.37±0.05)s、(0.66±0.05)s,均明显长于对照组[(1.15±0.06)步/s、(0.39±0.05)m、(0.31±0.06)s、(0.55±0.04)s],差异均有统计学意义(P<0.05)。治疗后,两组FAC评分均较治疗前明显升高,CSI评分较治疗前明显下降,且观察组的FAC评分为(4.31±0.72)分,明显高于对照组[(3.65±0.55)分],CSI评分为(6.55±1.94)分,明显低于对照组[(8.17±2.22)分],差异均有统计学意义(P<0.05)。结论功能性电刺激联合肌筋膜疼痛触发点针刺疗法能够有效提高脑卒中后痉挛型足下垂患者步态稳定性及肌张力,有利于患者步行功能恢复,值得临床推广应用。 展开更多
关键词 脑卒中 痉挛型足下垂 功能性电刺激 肌筋膜疼痛触发点针刺疗法 步态稳定性
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针刺联合经颅磁刺激治疗脑卒中后偏瘫足下垂的临床观察
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作者 黄春莉 韩冰 +1 位作者 王海涛 孙文 《广州中医药大学学报》 CAS 2023年第8期1960-1967,共8页
【目的】观察针刺联合经颅磁刺激治疗脑卒中后偏瘫足下垂的临床疗效。【方法】将120例患者随机分为针刺组、磁刺激组和联合组,每组各40例。针刺组给予针刺治疗,磁刺激组给予经颅磁刺激治疗,联合组给予针刺联合经颅磁刺激治疗,连续治疗4... 【目的】观察针刺联合经颅磁刺激治疗脑卒中后偏瘫足下垂的临床疗效。【方法】将120例患者随机分为针刺组、磁刺激组和联合组,每组各40例。针刺组给予针刺治疗,磁刺激组给予经颅磁刺激治疗,联合组给予针刺联合经颅磁刺激治疗,连续治疗4周。治疗4周后,评价3组临床疗效,观察3组患者治疗前后患侧腓肠肌外侧头、胫骨前肌最大积分肌电值(iEMG)的变化情况,以及下肢肌力和肌张力的情况。比较3组患者治疗前后步态运动参数、Fugl-Meyer下肢运动功能(FMA)评分及Barthel指数(BI)评分的变化情况,并评价3组的安全性。【结果】(1)联合组总有效率为95.00%(38/40),针刺组85.00%(34/40),磁刺激组为80.00%(32/40)。联合组疗效明显优于针刺组与磁刺激组,组间比较,差异有统计学意义(P<0.05)。(2)治疗后,3组患者的背伸时胫前肌群、跖屈时腓肠肌外侧头iEMG值均明显改善(P<0.05),且联合组在改善背伸时胫前肌群、跖屈时腓肠肌外侧头iEMG值方面明显优于针刺组与磁刺激组,差异有统计学意义(P<0.05)。针刺组与磁刺激组比较,差异无统计学意义(P>0.05)。(3)治疗后,3组患者的下肢肌力与肌张力水平均明显改善(P<0.05),且联合组在改善下肢肌力与肌张力方面明显优于针刺组与磁刺激组,差异均有统计学意义(P<0.05)。(4)治疗后,3组患者的步态运动参数均明显改善,且联合组在改善脚最大高度、患足着地角度、步频方面明显高于针刺组与磁刺激组,在双足站立相百分比方面明显低于针刺组与磁刺激组(P<0.05)。(5)治疗后,3组患者的FMA评分与BI评分均明显改善(P<0.05),且联合组在改善FMA评分与BI评分方面明显优于针刺组与磁刺激组,差异有统计学意义(P<0.05)。针刺组、磁刺激组比较,差异无统计学意义(P>0.05)。(6)3组患者的不良反应发生率比较,差异无统计学意义(P>0.05)。【结论】针刺联合经颅磁刺激治疗脑卒中后偏瘫足下垂,可明显改善患者的步态,调节患者下肢肌力和肌张力,提高患者的运动功能与日常生活能力,临床效果显著。 展开更多
关键词 针刺 经颅磁刺激 脑卒中 偏瘫 足下垂 运动功能 下肢肌力 临床观察
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肌电调制结合迭代学习控制的足下垂FES系统
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作者 王兆轩 李玉榕 陈楷 《仪器仪表学报》 EI CAS CSCD 北大核心 2023年第4期112-120,共9页
足下垂是指由于神经控制功能障碍导致踝关节无法产生背屈以致足尖上抬不完全或不能的现象。功能性电刺激(FES)作为纠正足下垂步态的治疗方法,通过低频脉冲刺激胫骨前肌引起肌肉收缩,使踝关节产生背屈动作,达到矫正足下垂的目的。本文提... 足下垂是指由于神经控制功能障碍导致踝关节无法产生背屈以致足尖上抬不完全或不能的现象。功能性电刺激(FES)作为纠正足下垂步态的治疗方法,通过低频脉冲刺激胫骨前肌引起肌肉收缩,使踝关节产生背屈动作,达到矫正足下垂的目的。本文提出了基于肌电(EMG)调制和迭代学习控制(ILC)的FES输出强度调制方法,利用小腿角速度信号通过动态BP神经网络预测健康步态胫骨前肌肌电信号,以脚尖俯仰角作为反馈信号通过ILC输出参考肌电信号,与神经网络预测的肌电信号加权平均得到修正后的肌电信号,最后利用肌肉激活特性调制FES输出。实验表明开环肌电调制模式下的脚尖俯仰角仅有17°左右,而在闭环调制模式下,脚尖俯仰角最大角度达到了21°左右。本文设计的FES控制系统可以帮助足下垂患者进行康复训练。 展开更多
关键词 功能性电刺激 足下垂 迭代学习控制 肌电信号
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