步行支持带联合常规康复治疗脑卒中患者步态的疗效观察  

The effects of using a walking support band on the gait of stroke survivors

作　　者：董晓琼[1] 吴月峰[1] 范虹[1] 张芳[1] 朱童[1] 朱海平[1] 章一锋 唐邵威 Dong Xiaoqiong;Wu Yuefeng;Fan Hong;Zhang Fang;Zhu Tong;Zhu Haiping;Zhang Yifeng;Tang Shaowei(Shaoxing People′s Hospital,Shaoxing 312000,China)

机构地区：[1]浙江省绍兴市人民医院康复医学科,绍兴312000

出　　处：《中华物理医学与康复杂志》2020年第6期528-532,共5页Chinese Journal of Physical Medicine and Rehabilitation

基　　金：浙江省医药卫生青年人才项目(2017RC028);绍兴市卫生计生科技计划青年项目(2017QN003)。

摘　　要：目的应用三维步态分析评价步行支持带联合常规康复治疗脑卒中患者步态的临床疗效。方法将脑卒中患者60例按随机数字表法随机分为步行支持带组20例、AFO组20例和常规治疗组20例。3组患者均接受常规康复治疗,步行支持带组患者采用步行支持带联合常规康复治疗,AFO组患者采用踝足矫形器联合常规康复治疗。于治疗前和治疗4周后(治疗后)采用三维步态分析评价3组患者的三维步态参数。结果共统计了57例患者,分别为步行支持带组(20例)、AFO组(19例)和常规治疗组(18例)。治疗后,3组患者的步速、步频和步长较组内治疗前均明显增加,而步宽、双支撑相百分比、健侧支撑相百分比、患侧支撑相百分比和健患侧支撑相比值较组内治疗前则明显减少,差异均有统计学意义(P<0.05)。治疗后,AFO组的步速、步频和步长较常规治疗组治疗后明显增加,步宽较常规治疗组明显减少(P<0.05);治疗后,步行支持带组的步速、步频和步长较常规治疗组治疗后明显增加,步宽、双支撑相百分比和健侧支撑相百分比较常规治疗组治疗后明显减少,差异均有统计学意义(P<0.05);治疗后,步行支持带组的双支撑相百分比为(32.05±5.26)%,健侧支撑相百分比为(69.15±2.41)%,较AFO组治疗后明显减少,差异均有统计学意义(P<0.05)。结论步行支持带联合常规康复治疗可明显改善脑卒中患者的异常步态,且在增加步行中的支撑能力方面优于踝足矫形器联合常规康复治疗。Objective To evaluate the effect of using a walking support band on the gait of stroke survivors.Methods Sixty stroke survivors were randomly divided into a walking support band group(n=20),an ankle foot orthosis(AFO)group(n=20)and a conventional rehabilitation group(n=20).All three groups received conventional rehabilitation therapy,while the AFO group members were additionally provided with an ankle-foot orthosis and the walking support band group members received training wearing a walking support band.Before and after 4 weeks of treatment,all three groups were evaluated using three-dimensional gait analysis.Results A total of 57 patients finished the study.After the interventions,the average step speed,frequency and step length of the three groups had all increased significantly,while the average stride width,the percentage of double stance phase,unaffected and affected side stance phase,and the ratio between unaffected and affected side stance phase had all decreased significantly.After the intervention,the average step speed,frequency and length of the AFO and walking support band groups had increased significantly compared with the conventional rehabilitation group,while the average stride width of the AFO group,and the stride width,the percentage of double stance phase and unaffected side stance phase of the walking support band group had decreased significantly.After the treatment,the average percentages of double stance phase and unaffected side stance phase of the walking support band group had decreased significantly more than in the AFO group.Conclusions A walking support band can significantly improve the abnormal gait of stroke survivors and is superior to an ankle-foot orthosis when combined with conventional rehabilitation therapy.

关 键 词：脑卒中 步行支持带 步态 三维步态分析 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R493[医药卫生—临床医学]