脑卒中偏瘫患者步态特征及其与STREAM量表下肢运动部分评分间的相关性分析  

Gait characteristics and their correlation with lower limb motor scores of STREAM scale in stroke patient with hemiplegia

作　　者：江炎[1] 周云[1] 刘奕[1] 丁呈彪[1] 冯小军[1] 冀磊磊 熊斌[1] JIANG Yan;ZHOU Yun;LIU Yi;DING Chen-biao;FENG Xiao-jun;JI Lei-lei;XIONG Bin(Department of Rehabilitation Medicine,The Second Affillated Hospital of Anhui Medical University,Hefei 230601,Anhui,China)

机构地区：[1]安徽医科大学第二附属医院康复医学科,安徽合肥230601

出　　处：《生物医学工程与临床》2023年第4期434-441,共8页Biomedical Engineering and Clinical Medicine

基　　金：2020年度安徽医科大学校科研基金(2020xkj030);2019年安徽省重点研究和开发计划项目(人口健康领域)(201904a07020067);2020年度安医大二附院-中科院合肥智能机械研究所“慢病防控联合研究基金”(MBLHJ202006);2020年安徽省科技厅重点研究与开发计划项目(202004j07020040);2021年安徽医科大学校级质量工程教学研究项目(2021xjjyxm49);安徽省卫生健康科研项目(AHWJ2022b063)。

摘　　要：脑卒中偏瘫患者的步态异常会严重影响其日常生活活动能力。步态分析作为定量评估方法已广泛应用于步态异常的科学研究,但步态分析数据繁杂,如何高效且规范化进行偏瘫患者的下肢运动功能的临床评估仍有待研究。目的探究脑卒中偏瘫患者步态特征,并通过步态特征及脑卒中康复运动评价(STREAM)量表下肢运动部分评分的相关性分析筛选出一些步态的定量指标为偏瘫患者的下肢运动功能的临床评估和诊断提供规范化数据。方法 选择2021年5月至2022年6月在安徽医科大学第二附属医院康复医学科接受治疗的脑卒中后偏瘫患者21例为卒中组,其中男性12例,女性9例;年龄14~77岁,平均年龄49.29岁;身高153~181 cm,平均身高168.90 cm;体质量53~94 kg,平均体质量69.88岁;其中脑出血恢复期患者9例,脑梗死恢复期患者12例。选取同时间段自愿参与该研究的健康者21例作为健康组,其中男性11例,女性10例;年龄24~71岁,平均年龄49.14岁;身高155~183 cm,平均身高167.67 cm;体质量48~80 kg,平均体质量65.95 kg。应用步态分析系统及运动障碍数字化测试平台分别采集两组受试者步态参数,对采集的数据进行统计分析,并对STREAM量表下肢运动部分评分与卒中组各指标进行相关性分析。结果 卒中组步幅小于健康组,步宽、触地时长百分比大于健康组,步速小于健康组,步相角大于健康组,差异均有统计学意义(P <0.05);两组T区、M1区、M2区足底压力占比差异均无统计学意义(P> 0.05);卒中组MF区压力占比较健康组高,差异有显著统计学意义(P <0.01);卒中组HEEL区压力占比较健康组低,差异有统计学意义(P <0.05);卒中组在COP-X、COP-Y方向的偏移值均高于健康组,差异均有统计学意义(P <0.05);卒中组患侧峰值屈髋角度较健康组减少,差异有统计学意义(P <0.05);卒中组患侧峰值屈膝角度较健康组减少,差异有统计学意义(P <0.05);�The abnormal gait of stroke patient with hemiplegia often seriously affects ability of their daily life. As a quantitative evaluation method, gait analysis has been widely used in scientific research of abnormal gait, but those data are complicated. Thus, efficient and standardized clinical evaluation of the lower limb motor function of hemiplegia patients still needs to be studied. Objective To explore the gait characteristics of stroke patients with hemiplegia, screen out some quantitative indicators of gait by correlation analysis of gait characteristics and lower limb motor scores of stroke rehabilitation exercise assessment(STREAM), and provide standardized data for clinical evaluation and diagnosis of lower limb motor function in hemiplegic patients. Methods From May 2021 to June 2022, 21 patients with hemiplegia after stroke were set as stroke group,which included 12 males and 9 females, aged 14-77 years old with mean age of 49.29 years old;height was 153-181 cm with mean height of 168.90 cm;body mass was 53-94 kg with mean of 69.88 kg;9 patients with cerebral hemorrhage recovery and 12 with cerebral infarction recovery. At the same time, 21 volunteers were selected as healthy group, which included11 males and 10 females, aged 24-71 years old with mean age of 49.14 years old;height was 155-183 cm with mean height of167.67 cm;body mass was 48-80 kg with mean mass of 65.95 kg. The gait analysis system and movement disorder digital test platform were used to collect gait parameters of 2 groups. Then, those collected data were statistically analyzed and correlation between STREAM lower limb movement score and indicators of stroke group was analyzed. Results Compared with healthy group,the step length of stroke group was shorter(P<0.05), percentage of step width and touchdown time were greater(P<0.05), step speed was slower(P<0.05), and foot angle was significant better than that of healthy group, and the differences were statistically significant(P<0.05). There were no significant differences in proportions of

关 键 词：脑卒中 偏瘫 步态分析 STREAM评分 相关性分析 

分 类 号：R743.3[医药卫生—神经病学与精神病学]