脑卒中偏瘫患者健侧膝关节的运动学特征观察  

Knee kinematics of uninjured knee in hemiplegic stroke patients during treadmill walking

作　　者：乔蕾[1] 蒙元孟 倪卫东 皇甫良 王少白 王晨 Qiao Lei;Meng Yuanmeng;Ni Weidong(Department of Rehabilitation Medicine,Shanghai Xuhui District Central Hospital,Shanghai 200031,China)

机构地区：[1]上海市徐汇区中心医院康复科,上海200031 [2]上海市逸动医学科技有限公司,上海201612 [3]宁波卫生职业技术学院,浙江宁波315100

出　　处：《中国康复》2020年第1期19-22,共4页Chinese Journal of Rehabilitation

基　　金：2015年上海市残联神经康复专科建设资助课题，2015年上海市临床重点专科（ZK2015A29）

摘　　要：目的:观察脑卒中偏瘫患者在异常步态时健侧膝关节的运动情况,为临床康复评定和治疗提供依据。方法:运用Opti-Knee膝关节运动功能参数检测仪对符合纳入标准的60例脑卒中偏瘫患者作为观察组进行步态分析,与其基本情况相匹配的健康者60例作为对照组,进行步行时健侧膝关节运动分析。评价2组间在步行中健侧膝关节6个自由度(屈伸、内外旋、内外翻、前后位移、上下位移、内外位移)的运动角度以及支撑期的最大伸角和摆动期的最大屈角的变化。结果:观察组脑卒中患者的健侧膝关节活动范围与对照组比较,其健侧膝的屈伸角、内外旋、内外翻的活动范围均显著小于正常组(P<0.01,P<0.05);与对照组比较,观察组脑卒中患者健侧膝的最大伸角和最大屈角均显著减小(P<0.05,0.01)。结论:通过Opti-Knee膝关节运动功能参数检测仪分析偏瘫患者健侧膝关节活动范围,可以帮助确定偏瘫步态基本特征,为下一步的康复训练提供临床依据。Objective:To investigate the kinematics of the knee on the uninjured side in the hemiplegic stroke patients during abnormal gait and provide basis for rehabilitation evaluation and clinical treatment.Methods:Gait analysis was performed on 60 cases of stroke hemiplegica,and 60 cases of healthy people who matched their basic conditions by aportable Opti_Knee motion analysis system.The 6 degree-of-freedom kinematics of the knee on the healthy side(flexion and extension,internal and external rotation,varus and valgus rotation,front and rear displacement,upper and lower displacement,medial and lateral displacement),maximum extension angle in the stance phase and maximum flexion angle in the swing phase were evaluated.Results:As compared with the control group,the range of motion of the knee(flexion-extension,internal-external rotation and varus-valgus rotation)on the healthy side in the observation group was significantly reduced(P <0.01,0.05).As compared with the control group,maximum extension angle and maximum flexion angle of of the knee on the uninjured side in the observation group were significantly reduced(P<0.05,0.01).Conclusion:The analysis of the knee motion angle on the healthy side of hemiplegic patients by the opti-knee motor function parameter detector can help determine the basic characteristics of hemiplegic gait and provide clinical basis for the next step of rehabilitation training.

关 键 词：脑卒中 运动捕捉 健侧 膝关节 偏瘫步态 

分 类 号：R49[医药卫生—康复医学] R743.3[医药卫生—临床医学]