踝足矫形器早期应用对卒中患者足踝控制能力的sEMG研究  

sEMG Study on Ankle Foot Control Ability in Stroke Patients with Application of Ankle Foot Orthosis in Early Stage

作　　者：高润[1] 孙丰[1] 叶强[2] 钱竞光[2] 张剑[3] 

机构地区：[1]南京医科大学附属脑科医院神经精神病学研究所,南京210029 [2]南京体育学院运动人体科学系,南京210000 [3]上海体育学院运动科学学院,上海200438

出　　处：《中国康复》2011年第1期13-15,共3页Chinese Journal of Rehabilitation

基　　金：南京市医学科技发展重点项目资助(No.ZKX06026)

摘　　要：目的:本文探讨足踝矫形器早期应用对脑卒中偏瘫患者足踝控制能力的作用及价值。方法:诊断明确的脑卒中患者48例,随机分为早期支具组(ZJ组)和对照组(D组)各24例,均按常规对症支持治疗。ZJ组早期患足加穿定制的硬塑固定踝足矫形器,D组则病程>1个月后开始穿戴或不戴。2组均在治疗前后进行表面肌电图(sEMG)检测及下降Fugl-Meyer(FMA)评定。结果:治疗1个月后,小腿胫前肌、腓肠肌积分肌电值(iEMG值)与治疗前比较,2组均明显增加,下肢简化FMA评分均明显提高(均P<0.01)。腓肠肌iEMG值在踝关节背伸等长收缩时小腿肌群的协同收缩率,ZJ组明显低于D组(P<0.05)。结论:早期使用踝足矫形器可有效缓解踝背伸活动时拮抗肌的痉挛、增强胫前肌肌力,改善踝关节活动范围,对促进足下垂的恢复有明显作用。Objective：To investigate the efficacy of early application of ankle foot orthosis（AFO） for ankle foot control ability in stroke patients and the applied value of AFO.Methods：Forty-eight stroke patients were randomly divided into group A and group B.The patients in both groups were treated with routine therapy.The patients in group A were treated with custom-made ARO in early period,while those in group B were treated without or with AFO after 1 month.All the patients received sEMG assessment and were evaluated with Fugl-Meyer scale before and after treatments.The patients in group A with application of AFO received reevaluation every other week.The data were statistically analyzed with SPSS software.Results：After treatment for 1 month,the iEMG scores of gastrocnemius in group B were higher than in group A（P0.05）.The coordinated muscle contract rate of ankle joint extension was significantly decreased in both two groups after treatment（P0.01）,and that in group A was lower than in group B（P0.05）.The scores of Fugl-Meyer scale in both two groups were significantly increased after treatment（P0.05）.Conclusion：The early application of AFO could effectively relieve the spasm of gastrocnemius and strengthen the tibialis anterior in ankle joint extension.It could improve the range of motion of ankle joint and promote the recovery of foot drop.

关 键 词：踝足矫形器 早期应用 脑卒中 足踝控制能力 SEMG 

分 类 号：R49[医药卫生—康复医学] R454[医药卫生—临床医学]