骶髂关节半脱位矫正对慢性期卒中后功能障碍恢复的影响  

Effects of Correction of Sacroiliac Joint Subluxation on Rehabilitation of Functional Impairment in Patients with Chronic Stroke

作　　者：付琨燕 项文平[3] 杨志刚[3] 何飞[4] 满乾坤 王雅明 牛翻燕 岳雅蓉 FU Kunyan;XIANG Wenping;YANG Zhigang;HE Fei;MAN Qiankun;WANG Yaming;NIU Fanyan;YUE Yarong(Graduate School,Baotou Medical College,Inner Mongolia University of Science and Technology,Baotou 014000,China;Department of Neurology,Bayannur City Hospital,Bayannur 015000,China;Department of Geriatrics,Baotou Central Hospital,Baotou 014000,China;Department of Neurology,Baotou Central Hospital,Baotou 014000,China)

机构地区：[1]内蒙古科技大学包头医学院研究生院,包头014000 [2]巴彦淖尔市医院神经内科 [3]包头市中心医院老年医学科 [4]包头市中心医院神经内科

出　　处：《中国卒中杂志》2023年第1期90-96,共7页Chinese Journal of Stroke

基　　金：包头市卫生健康科技计划项目(wsjkkj066)。

摘　　要：目的初步探讨矫正骶髂关节半脱位对慢性期卒中偏瘫患者步行能力及平衡功能的影响。方法选择2018年4月—2021年12月在包头市中心医院神经康复中心住院且符合入组标准的慢性期卒中偏瘫患者,对确定存在骶髂关节半脱位的13例患者进行手法矫正治疗。治疗前、治疗3周后进行Berg平衡量表评估、“起立-行走”计时测试、10米步行计时测试、Holden步行能力分级以及骨盆正位X线片检查,并进行比较。结果存在骶髂关节半脱位的慢性期卒中偏瘫患者共11例纳入研究。按冈斯德分析系统进行骨盆正位X线片画线测量,其中髂骨ASIn7例,髂骨ASEx2例,髂骨PIIn1例,髂骨In1例。手法矫正治疗3周后,Berg平衡量表评分高于治疗前[(47.00±9.22)分vs.(37.45±11.04)分,P<0.001];“起立-行走”计时测试时间短于治疗前[(18.51±5.29)s vs.(24.94±9.50)s,P=0.003];10米步行计时测试:步行速度较治疗前变快[(53.72±25.71)cm/s vs.(43.49±24.24)cm/s,P<0.001],步长较治疗前增加[(38.37±9.87)cm vs.(34.49±9.32)cm,P=0.022];Holden步行能力分级高于治疗前(2级∶3级∶4级∶5级=0∶2∶4∶5 vs.1∶6∶4∶0,P=0.002)。结论对于存在骶髂关节半脱位的慢性期卒中偏瘫患者,骶髂关节半脱位手法矫正治疗有助于患者步行能力及平衡功能的改善。Objective To explore the effects of correcting sacroiliac joint subluxation on rehabilitation of walking ability and balance function in patients with chronic stroke hemiplegia.Methods The inpatients with hemiplegia after chronic stroke in Neurological Rehabilitation Center of Baotou Central Hospital from April 2018 to December 2021 were selected,and 13patients with sacroiliac joint subluxation who received manipulative treatment among them were included in this study.The Berg balance scale,the timed up and go(TUG)te st,the 10 meters walk(l0mW)test,Holden walking ability rating,and the pelvis AP radiographs were compared before treatment and 3 weeks after treatment.Results A total of 11 eligible patients were included in the final analysis.According to the Gunsted analysis system,the pelvis radiographs showed 7 cases with ASIn,2 cases with ASEx,1 case with PIIn,and 1 case with In.Compared to before treatment,the assessment scales results at 3 weeks after treatment were as follows:the score of Berg balance scale was higher[(47.00±9.22)points vs.(37.45±11.04)points,P<0.001],the TUG time was shorter[(18.51±5.29)s vs.(24.94±9.50)s,P=0.003],the walking speed in 10mW test was faster[(53.72±25.71)cm/s vs.(43.49±24.24)cm/s,P<0.001]and the step length was increased[(38.37±9.87)cm vs.(34.49±9.32)cm,P=0.022],and the grade of Holden walking ability rating was higher(grade 2:grade 3:grade4:grade 5=0:2:4:5 vs.1:6:4:0,P=0.002).Conclusions For hemiplegia patients with chronic stroke and sacroiliac joint subluxation,manipulative treatment for sacroiliac joint subluxation can improve patients’walking ability and balance function.

关 键 词：骶髂关节 半脱位 卒中 功能障碍 

分 类 号：R743.3[医药卫生—神经病学与精神病学]