脑卒中后偏瘫侧手佩戴手功能支具对患者步态时空参数的影响  

The effect of wearing the orthosis of hand function on gait spatiotemporal parameters in patients with hemiplegia after stroke

作　　者：陈祥贵 刘迟[1] 陈树耿 贾杰[1,2,3] CHEN Xianggui;LIU Chi;CHEN Shugeng;JIA Jie(Department of Rehabilitation,Shanghai Jing’an District Central Hospital,Shanghai 200040,China;Departmentof Rehabilitation,Huashan Hospital,Fudan University,Shanghai 200040,China;National Clinical MedicalResearch Center for Geriatric Diseases(Huashan),Shanghai 200032,China)

机构地区：[1]上海市静安区中心医院康复科,上海200040 [2]复旦大学附属华山医院康复科,上海200040 [3]国家老年疾病临床医学研究中心(华山),上海200032

出　　处：《上海医药》2024年第13期38-43,共6页Shanghai Medical & Pharmaceutical Journal

基　　金：国家重点研发计划“主动健康和老龄化科技应对”重点专项项目(2018YFC2002300、2018YFC2002301);上海市科学技术委员会课题(15441901601、16441905303);上海市静安区卫生系统重点学科建设资助项目(2021ZB02)。

摘　　要：目的:考察脑卒中后偏瘫侧手佩戴手功能支具对患者三维步态的影响。方法:本试验为组间一次性干预对照研究,通过对40例脑卒中患者偏瘫侧手佩戴手功能支具前后全身三维步态分析系统的测试,采集干预前后患者三维步态的时空和运动学参数并进行比较。结果:佩戴手功能支具可显著改善脑卒中偏瘫患者的步行能力和步态:患者步频、步速显著提高(P<0.001),患侧步长增大(P<0.001),患侧支撑相缩短(P<0.05)、摆动相增长(P<0.05)。患者健侧的时空参数和下肢运动学参数在患侧手佩戴手功能支具前后无明显变化。结论:手部肌张力高的脑卒中后遗症期患者患侧手佩戴手功能支具能改善步速和步态,其原理可通过“上下肢一体化”理论予以解释。该干预方法有在临床上进一步研究的价值,同时对进一步探究脑卒中偏瘫患者手功能改善对其下肢及整体步态、步行能力改善的机制亦有参考价值。Objective:To investigate the effect of hemiplegic lateral hand wearing a hand functional brace on the three-dimensional gait of patients after stroke.Methods:This experiment was a one-time intervention control study between groups.The whole body three-dimensional gait analysis system was tested before and after wearing a hand functional brace in 40 stroke patients,and the spatiotemporal and kinematic parameters of the three-dimensional gait were collected and compared before and after intervention.Results:The walking ability and gait of the patients could be significantly improved by wearing a hand functional brace,their cadence and gait speed were significantly increased(P<0.001),the stride length of the affected side was increased(P<0.001),the support phase of the affected side was shortened(P<0.05),and the swing phase was increased(P<0.05).There were no significant differences in the spatiotemporal and kinematic parameters before and after intervention.Conclusion:Wearing hand functional braces on the affected side of stroke patients with sequelae of high hand muscle tone can improve walking speed and gait,which may be explained by the theory of“upper and lower limb integration”.This intervention method has further clinical research value,and also has reference value for further exploring the mechanism of hand function improvement on lower limb and overall gait and walking ability improvement.

关 键 词：脑卒中 手功能支具 三维步态分析系统 上下肢一体化 

分 类 号：R493[医药卫生—康复医学] R743.3[医药卫生—临床医学]