静态踝足矫形器与调谐静态踝足矫形器对脑瘫患儿异常步态及血清VEGF CK-BB水平的影响比较  

Comparison of the Effects of Solid Ankle-Foot Orthosis and Tuned Solid Ankle-Foot Orthosis on Abnormal Gait and Serum VEGF and CK-BB Levels in Children with Cerebral Palsy

作　　者：赵乐[1] 高峰[1] 邱志伟 余丹[1] 孙杰 ZHAO Le;GAO Feng;QIU Zhiwei(Taihe Hospital of Shiyan, Hubei Shiyan 442000, China)

机构地区：[1]湖北省十堰市太和医院,湖北十堰442000 [2]湖北省十堰市人民医院康复科,湖北十堰442000

出　　处：《河北医学》2020年第9期1417-1420,共4页Hebei Medicine

基　　金：湖北省自然科学基金,(编号:2017CFB825)。

摘　　要：目的:探讨静态踝足矫形器与调谐静态踝足矫形器对脑瘫患儿异常步态的影响。方法:选取我院2017年6月至2019年6月收治的脑瘫患儿80例,根据随机数字表采用简单随机分组法分为观察组和对照组,每组各40例。对照组配置静态踝足矫形器,观察组配置调谐静态踝足矫形器。观察比较两组患儿运动时空间参数、肢体运动学参数、肢体动力学参数及血清血管内皮生长因子(vascular endothelial growth factor,VEGF)和肌酸激酶脑同工酶(Creatine kinase brain isoenzyme,CK-BB)水平。结果:观察组与对照组相比,患儿步频、步速均更高,膝关节活动度更高,首次触地膝关节屈曲角度更低,站立膝关节最大伸展角度、摆动期踝关节最大背屈角度更大,膝关节最大屈力矩更大,伸力矩更小,踝关节最大跖屈力矩更大,背屈力矩更小,血清VEGF、CK-BB水平均更低,差异具有统计学意义(P<0.05)。结论:脑瘫患儿佩戴调谐静态踝足矫形器比佩戴静态踝足矫形器对异常步态改善效果更好,步态更稳定,连贯,患儿血清VEGF、CK-BB水平更低,值得在临床上推广。Objective:To investigate the effects of solid ankle-foot orthosis and tuned solid ankle-foot orthosis on abnormal gait in children with cerebral palsy.Methods:80 children with cerebral palsy treated in our hospital from June 2017 to June 2019 were selected and randomly divided into observation group(n=40)and control group(n=40)with simple random number table method.The control group was equipped with solid ankle-foot orthosis and the observation group was equipped with tuned solid ankle-foot orthosis.The spatial parameters,limb kinematic parameters,limb kinetic parameters and serum levels of vascular endothelial growth factor(VEGF)and creatine kinase brain isoenzyme(CK-BB)were observed and compared between the two groups.Results:Compared with the control group,the observation group had higher walking frequency and speed,higher range of motion of knee joint,lower flexion angle of knee joint touching the ground for the first time,larger maximum extension angle of standing knee joint and maximum dorsiflexion angle of ankle joint during swing,larger maximum flexion moment of knee joint,smaller extension moment,larger maximum metatarsal flexion moment of ankle joint,smaller dorsal flexion moment,lower serum VEGF and CK-BB levels.The difference was statistically significant(P<0.05).Conclusion:Wearing tuned solid ankle-foot orthosis is better than solid ankle-foot orthosis in improving abnormal gait(more stable and coherent)with lower levels of serum VEGF and CK-BB in children with cerebral palsy,which is worth promotion in clinical practice.

关 键 词：脑瘫 静态踝足矫形器 调谐静态踝足矫形器 步态 血管内皮生长因子 肌酸激酶脑同工酶 

分 类 号：R72[医药卫生—儿科]