前交叉韧带重建后静态站立及步行时的平衡和步态特征  

Balance and gait characteristics of static standing and walking after anterior cruciate ligament reconstruction

作　　者：马圣楠 柯竟悦 董洪铭 沈双[2] 丁浩 李建萍 李古强[2] Ma Shengnan;Ke Jingyue;Dong Hongming;Shen Shuang;Ding Hao;Li Jianping;Li Guqiang(School of Rehabilitation,Binzhou Medical University,Yantai 264003,Shandong Province,China;Rehabilitation Engineering Research Institute,Binzhou Medical University,Yantai 264003,Shandong Province,China;Second Clinical Medical College,Binzhou Medical University,Yantai 264003,Shandong Province,China)

机构地区：[1]滨州医学院康复医学院,山东省烟台市264003 [2]滨州医学院康复工程研究院,山东省烟台市264003 [3]滨州医学院第二临床医学院,山东省烟台市264003

出　　处：《中国组织工程研究》2023年第36期5784-5789,共6页Chinese Journal of Tissue Engineering Research

基　　金：山东省自然科学基金面上项目(ZR2022MA047),项目负责人:沈双;2021年山东省本科教学改革研究面上项目《假肢矫形工程医工融合产学研协同育人探索》(M2021213),项目负责人:李古强。

摘　　要：背景:前交叉韧带断裂是常见运动损伤之一,一般采用前交叉韧带重建治疗,术后常出现平衡及步行能力下降,目前缺少相关的全面对比研究。目的:探究前交叉韧带重建后患者静态站立和步行时的平衡及步态特征,并与健康人做全面对比分析,为康复方案的制定提供科学指导。方法:选择前交叉韧带重建后6-8周患者和健康人(健康对照组)各23例,利用足底压力平板采集静态站立时足底压力中心95%置信椭圆面积、路径长度、平均移动速度及长短轴长度,同时采集步行时的足底压力中心位移、步态线长度、最大移动速度、步态时相占比以及三足区的最大压力。结果与结论:(1)静态站立平衡:前交叉韧带重建组的足底压力中心95%椭圆面积、路径长度、平均移动速度、长短轴长度较健康对照组明显增加(P<0.05),同时站立时前交叉韧带重建组前足负重大于健康对照组(P<0.05);(2)步行平衡特征:前交叉韧带重建组与健康对照组比较,足底压力中心内外侧位移显著变大(P<0.05),前后方向位移和最大移动速度无明显差异;前交叉韧带重建组患侧与健侧、患侧与健康对照组、健侧与健康对照组相比,前者的步态线和单支撑线长度均小于后者(P<0.05);(3)步态周期特征:前交叉韧带重建组的步宽及双支撑期均大于健康对照组(P<0.05),跨步长小于健康对照组(P<0.05);前交叉韧带重建组患侧与健侧比较,站立相、单腿支撑期、摆动前期及足跟到前足时间均减少(P<0.05),而承重反应期和摆动期增加(P<0.05);患侧与健康对照组相比,足偏角、承重反应期和摆动前期增加,单腿支撑期降低(P<0.05);健侧与健康对照组相比,站立相、承重反应期、摆动前期及足跟到前足时间均明显增加,摆动期减少(P<0.05);(4)三足区最大压力:患侧与健侧比较,前足、足弓和足跟的最大压力均显著降低(P<0.05);患侧与健康对照组比较,三足BACKGROUND:Anterior cruciate ligament rupture is one of the common sports injuries,which is generally treated by anterior cruciate ligament reconstruction.Balance and walking abilities are often decreased after surgery,and there is a lack of comprehensive comparative study.OBJECTIVE:To explore the balance and gait characteristics of patients after anterior cruciate ligament reconstruction during static standing and walking,and make a comprehensive comparative analysis with the healthy group to provide scientific guidance for rehabilitation treatment.METHODS:Totally 23 patients 6-8 weeks after anterior cruciate ligament reconstruction and 23 healthy controls were selected.The plantar pressure plate was used to collect 95%confidence elliptical area,path length,average velocity and major and minor axis length of the plantar center of pressure during static standing.Simultaneously,the center of pressure displacement,gait line length,maximum velocity,gait phase ratio and maximum pressure in the tripod area were collected.RESULTS AND CONCLUSION:(1)Static standing balance:The center of pressure 95%confidence ellipse area,path length,average moving speed and length of major and minor axes in the anterior cruciate ligament reconstruction group were significantly higher than those in the healthy control group(P<0.05).Simultaneously,the weight-bearing of the forefoot in the anterior cruciate ligament reconstruction group was higher than that in the healthy control group(P<0.05).(2)Characteristics of walking balance:Compared with the healthy control group,the medial and lateral displacement of the center of pressure in the anterior cruciate ligament reconstruction group was significantly larger(P<0.05),and there was no significant difference in anterior and posterior displacement and maximum movement speed.Compared with the affected side and the healthy side in the anterior cruciate ligament reconstruction group,the affected side and the healthy control group,and the healthy side and the healthy control group,the gait line a

关 键 词：前交叉韧带重建 静态平衡 步态周期 足底压力中心 步态线长度 前后方向位移 内外侧位移 最大移动速度 足底压力 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学] R493