矫形足垫对脑卒中后偏瘫患者平衡和步行运动功能的影响  

Effects of ICB orthopedic sole on balance and walking function in stroke survivors with hemiplegia

作　　者：顾昭华 王盛 孟殿怀 龚晨 王翔 罗予 王彤 

机构地区：[1]南京医科大学第一附属医院康复医学科,南京210014

出　　处：《中华物理医学与康复杂志》2015年第8期597-599,共3页Chinese Journal of Physical Medicine and Rehabilitation

摘　　要：目的观察国际生物力学学院（ICB）矫形足垫结合康复训练对脑卒中偏瘫患者平衡和步行运动功能的影响。方法选取脑卒中后偏瘫患者30例，按随机数字表法分为观察组15例和对照组15例，对照组采用以运动再学习技术为主的训练，并结合核心肌群控制训练；观察组在对照组训练计划的基础上加用ICB矫形足垫进行患腿负重控制训练，并要求患者日常生活中穿戴矫形足垫步行。于治疗前和治疗4周后（治疗后）分别测量2组患者的下肢立姿跟骨休息位角度（RCSP）、胫骨扭转角度（MP）和前足角度（FP），同时采用Berg平衡量表（BBS）、运动功能评估量表（MAS）以及10m最大步行速度（MWS）分别评估2组患者的平衡功能、步行功能和步行速度。并进行统计学分析比较。结果治疗后，除对照组FP外，2组患者其余各项指标与组内治疗前比较，差异均有统计学意义（P〈0．05）。治疗后，治疗组的RCSP和MP分别为（1．78±0．32）°和（13．33±2．51）°，与对照组治疗后的（2．58±0．59）°和（12．45±3．31）°比较，差异均有统计学意义（P〈0．05）；治疗组治疗后的BBS和MAS评分以及MWS分别与对照组治疗后比较，差异亦均有统计学意义（P〈0．05）。结论ICB矫形足垫结合康复训练可显著改善脑卒中后偏瘫患者患侧下肢负重时的控制能力，促进其平衡和步行运动能力恢复。Objective To observe the effects of ICB orthopedic sole combined with rehabilitation training on balance and walking function in stroke survivors. Methods Thirty hemiplegic stroke patients were recruited and divided into a study group （n = 15） and a control group （n = 15） by using a random number table. Both groups took exercises based on the principles of a motor relearning program and conducted core stability control training, and the study group additionally undertook hemiplegic lower extremity weight-bearing exercises and walking with ICB orthopedie sole used in daily living. The program was administered 20 rain twice per day for 4 weeks. All patients were evaluated with Rest Calcaneus Standing Position （RCSP） , Malleolar Position （MP） , Forefoot Position （FP） , Berg Balance Scale （BBS） , 10 m Maximum Walking Speed （MWS） and walking section of Motor Assessment Scale （MAS） before and after the program. Results After 4 weeks of intervention, all themeasurements except the FP in both groups improved significantly, and significant differences were observed between the two groups. After 4 weeks of training, the average RCSP （ 1.78 ± 0.32）° and MP （ 13.33 ± 2.51 ） ° were improved significantly compared to those of the control group [ （2.58 ± 0.59 ） ° and （ 12.45 ± 3.31 ）°, respectively ]. Moreover, the average BBS, MAS and MWS improved significantly compared to the control group. Conclusions ICB orthopedic sole combined with rehabilitation training can improve the weight-bearing, balance and ambulation abilities of stroke survivors.

关 键 词：矫形足垫 脑卒中 平衡 步行功能 

分 类 号：R743.3[医药卫生—神经病学与精神病学]