调肾通督健脑法推拿联合3D矫形鞋垫对痉挛型双瘫患儿下肢生物力学及三维步态时-空参数的影响  

Effects of Kidney-Regulating,Governor Vessel-Dredging,and Brain-Strengthening Massage Combined with 3D Orthopedic Insoles on Biomechanics and Three-Dimensional Gait Time-Space Parameters of Lower Limbs in Children with Spastic Diplegia

作　　者：黄绍雄 马竞 周信波 王琛琰 宋伟 王子聪 罗秋 刘海婷 HUANG Shaoxiong;MA Jing;ZHOU Xinbo;WANG Chenyan;SONG Wei;WANG Zicong;LUO Qiu;LIU Haiting(Nuclear Industry 416 Hospital,The Second Affili-ated Hospital of Chengdu Medical College,Chengdu 610057,China;Chengdu Fu’ertai Orthopedic Reha-bilitation Equipment Co.,Ltd.Chengdu 610021,China;Hospital of Chengdu University of Tradi-tional Chinese Medicine,Chengdu 610075,China)

机构地区：[1]成都医学院附属第二医院核工业四一六医院,四川成都610057 [2]成都福尔泰矫形康复器材有限公司,四川成都610021 [3]成都中医药大学附属医院,四川成都610075

出　　处：《山东中医杂志》2024年第2期153-159,216,共8页Shandong Journal of Traditional Chinese Medicine

基　　金：四川省卫生与计划生育委员会科研课题项目(编号:18PJ518);四川省中医药管理局科研课题项目(编号:2020LC0198)。

摘　　要：目的:观察调肾通督健脑法推拿联合3D矫形鞋垫对痉挛型双瘫患儿下肢生物力学及三维步态时-空参数的影响。方法:将162例痉挛型双瘫患儿按随机数字表法分为对照组、观察1组和观察2组各54例。对照组采用常规康复治疗,观察1组在对照组基础上加用3D矫形鞋垫,观察2组在观察1组基础上加用调肾通督健脑法推拿。治疗前和治疗8周后,对三组患儿进行Berg平衡量表(BBS)评分、粗大运动功能评定量表(GMFM)中的D功能区、E功能区评分和下肢生物力学评估[包括立姿跟骨休息位(RCSP)角度、腓肠肌平均肌电信号均方根值(RMS)和超声剪切波弹性成像(SWE)],检测三组患儿三维步态时-空参数(包括步行周期、步速、步长、单支撑时间及髋、膝、踝关节最大屈曲度)。结果:量表评分方面,观察2组GMFM的D功能区和E功能区评分均高于其他两组(P<0.05);观察2组BBS评分高于对照组(P<0.05)。生物力学方面,观察2组左、右侧RCSP角度、腓肠肌RMS以及SWE腓肠肌Emean值均低于其他两组(P<0.05)。三维步态时-空参数方面,观察2组步长以及髋关节、膝关节、踝关节最大屈曲度均大于其他两组(P<0.05),单支撑时间短于其他两组(P<0.05);步速高于对照组(P<0.05)。结论:调肾通督健脑法推拿联合3D矫形鞋垫可以通过纠正下肢力学分布、缓解痉挛改善痉挛型双瘫患儿的平衡功能和下肢运动功能。Objective:To observe the effects of kidney-regulating,governor vessel-dredging,and brainstrengthening massage combined with 3D orthopedic insoles on the biomechanics and three-dimensional gait time-space parameters of lower limbs in children with spastic diplegia.Methods:A total of 162 children with spastic diplegia were divided into a control group,observation group 1,and observation group 2 by the random number table method,with 54 cases in each group.The control group received conventional rehabili⁃tation treatment,the observation group 1 received 3D orthopedic insoles in addition to the control group’s treatment,and the observation group 2 received kidney-regulating,governor vessel-dredging,and brainstrengthening massage in addition to the observation group 1’s treatment.Before the treatment and after 8 weeks of the treatment,the Berg balance scale(BBS)scores,gross motor function measure(GMFM)scores of sections D and E,and lower limb biomechanical assessments[including resting calcaneal stance position(RCSP)angles,average root mean square values of gastrocnemius muscle electromyography signals(RMS),and shear wave elastography(SWE)]were conducted for the children in all the three groups,along with the measurement of three-dimensional gait time-space parameters(including walking cycle,walking speed,stride length,single-limb support time,and maximum flexion angles of the hip,knee,and ankle joints).Results:In terms of scale scores,observation group 2 scored higher in the D and E sections of the GMFM than the other two groups(P<0.05).The BBS score of the observation group 2 was higher than that of the control group(P<0.05).In terms of biomechanics,the RCSP angles on the left and right sides,gastrocnemius RMS,and SWE gastrocnemius Emean values of the observation group 2 were lower than those of the other two groups(P<0.05).In terms of three-dimensional gait time-space parameters,the observation group 2 had greater stride length and maximum flexion angles of the hip,knee,and ankle joints than the other two gro

关 键 词：调肾通督健脑法推拿 3D矫形鞋垫 脑瘫 痉挛型 下肢生物力学 三维步态时-空参数 

分 类 号：R277.7[医药卫生—中医学]