计算机辅助步态分析评价体外冲击波疗法治疗膝骨关节炎的效果  

Computer-aided gait analysis evaluate the extracorporeal shock wave therapy in the treatment of knee osteoarthritis

作　　者：刘水涛[1] 刘彧[2] 杨军[3] 赵斌[3] 邢更彦[4] 

机构地区：[1]武警后勤学院附属医院骨科,天津300162 [2]河北医科大学第三医院骨肿瘤科,石家庄050051 [3]中国武警总医院关节四肢外科,北京100039 [4]武警总医院骨科中心,北京100039

出　　处：《中国医学前沿杂志（电子版）》2016年第3期12-15,共4页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

基　　金：国家自然科学基金(31172169);武警总医院苗圃基金(WZ2012055)

摘　　要：目的以计算机辅助步态分析为主要评价手段,探讨体外冲击波疗法治疗膝骨关节炎（knee osteoarthritis,KOA）的效果。方法选取2015年3月至2015年6月本院收治的25例KOA患者为研究对象,均接受发散式体外冲击波（extracorporeal shock wave,ESW）治疗,治疗频率为3 Hz,能量为1~2bar,每次冲击2000频次,每周接受1次治疗,8次为一疗程。所有患者均于治疗前及治疗后1、3、6个月行计算机辅助步态分析,收集时间-距离指标：支撑期百分比（%）、摆动期百分比（%）、步长（cm）、步速（m/s）的变化,应用统计学软件进行分析。结果经ESW治疗后,患者步长较治疗前无显著改善（P〉0.05）,而步速在治疗后1个月[（0.92±0.11）m/s]、3个月[（1.09±0.11）m/s]及6个月[（1.12±0.13）m/s]均较治疗前[（1.13±0.12）m/s]显著增加（P〈0.05）。患者治疗后1个月时站立期时相[（61.78±1.47）%]与摆动期时相[（38.22±1.75）%]均较治疗前[（62.68±1.79）%、（37.32±1.36）%]显著改变（P〈0.05）,而其他时间点较治疗前无显著变化（P〉0.05）。结论 ESW可使KOA患者膝关节功能得到一定恢复,尤其是明显提高治疗后1、3、6个月步速,步态分析较其他指标具有客观、精确、定量的优势,是评价膝关节功能变化的全新方法。Objective With computer-aided gait analysis as the main evaluation tools to evaluate the effect of extracorporeal shock wave therapy for knee osteoarthritis（KOA）. Method From March 2015 to June 2015, 25 cases of KOA patients in our hospital were selected as study subjects, all the patients were given radial extracorporeal shock wave therapy, treatment frequency was 3 Hz, 1 ~ 2 energy bar, under the shock of 2000 per week, received treatment once per week, 8 times for a course of treatment. Patients gait analysis before and at 1 month, 3 months, 6 months, collected time indicator： stance（%）, swing（%）, stride length（cm）, wailing speed（m/s）, analysis by used statistical software. Result After ESW treatment, patients＇ stride length（cm） compared with before treatment had no significant improvement（P 0.05）, and wailing speed（m/s）in the treatment of 1 momth [（0.92±0.11） m/s], 3 months [（1.09±0.11） m/s] and 6 months [（1.12±0.13） m/s] had significant improvement than before treatment [（1.13±0.12） m/s]（P 0.05）. At 1 month, stance [（61.78±1.47）%] and swing [（38.22±1.75）%] compared with before treatment [（62.68±1.79）%,（37.32±1.36）%] were significantly changed（P 0.05）, and other points had no significant changes（P 0.05）. Conclusion ESW can restore the patients＇ knee function of with KOA, especially at 1, 3 and 6 months after treatment, the wailing speed（m/s） is significantly improved. Gait analysis relative to other indicators is objective, accurate and quantitative advantages, is a new method for evaluating functional changes.

关 键 词：膝骨关节炎 步态分析 体外冲击波 

分 类 号：R684.3[医药卫生—骨科学]