踝足矫形器的早期应用对脑卒中患者日常生活活动能力及生活质量影响的临床研究  

The clinical efficacy of early intervention treatment on activities of daily living and quality of life with ankle-foot orthosis in stroke patients

作　　者：高亚南[1] 付彦[2] 邢方印[1] 许永利[1] 李春璐[1] 陈雪丽[1] 

机构地区：[1]北京老年医院康复医学科,100095 [2]北京老年医院卒中单元,100095

出　　处：《北京医学》2018年第1期42-44,共3页Beijing Medical Journal

基　　金：北京市医院管理局"青苗计划"(QML20152001);首都卫生发展科研专项(2016-3-2191)

摘　　要：目的探讨踝足矫形器(ankle-foot orthosis,AFO)的早期干预治疗在改善脑卒中早期患者日常生活活动能力及生活质量影响中的作用。方法将80例脑卒中早期患者随机分为早期AFO治疗组和对照组,每组40例,入院24 h内对两组的患侧踝关节背伸活动度、Barthel指数评定量表(modified barthel index,MBI)评分及SF-36生活质量量表进行初次评定。对照组给于常规神经内科治疗及康复治疗,治疗组在此基础上于早期卧床时开始使用轻型高温热塑AFO,每日至少佩戴12 h。每月治疗后再次进行评定,12周治疗结束后,对两组患者的患侧步频、10 m自由步行速度、患侧跨步长进行最后评定。结果治疗后,治疗组患者的10 m自由步行速度[治疗组(0.58±0.31)m/s,对照组(0.30±0.21)m/s]、步频[(治疗组(82.50±4.31)步/m,对照组(51.30±5.21)步/m]、踝关节背伸活动度[治疗组(32.32±5.47)°,对照组(12.56±5.13)°]、日常生活活动能力[治疗组(75.21±15.23),对照组(43.52±12.37)]较对照组明显提高,差异均有统计学意义(P<0.05或<0.01)。结论 AFO的早期干预治疗可明显改善脑卒中偏瘫患者的步态和日常生活活动能力。Objective To discuss the effect of early intervention treatment with ankle-foot orthosis（AFO） on activities of daily living（ADL） and quality of life in stroke patients. Methods Eighty stroke patients were randomly divided into treatment group and control group, with 40 cases in each group. The patients of the two groups were treated with routine rehabilitation and medications; while those of the treatment group trained early with AFO every day in addition. Results After 12 weeks treatment, 10 m self-selected walking speed [（0.58±0.31） m/s vs.（0.30±0.21） m/s], cadence [（82.50±4.31） step/m vs.（51.30 ±5.21） step/m], ADL（75.21±15.23 vs. 43.52±12.37） and the active range of motion（AROM） of ankle extension in the sick side（32.32±5.47 vs. 12.56±5.13） of the patients in the treatment group improved significantly better than those in control group（P〈0.05）. Conclusion The early intervention treatment with AFO can obviously improve the lower limb motor function and ADL of stroke patients.

关 键 词：脑卒中 踝足矫形器 早期干预治疗 日常生活活动能力 

分 类 号：R493[医药卫生—康复医学] R743.3[医药卫生—临床医学]