膝控制矫形器治疗老年重症卒中偏瘫患者康复疗效观察

目的探讨穿戴膝控制矫形器进行康复治疗对中老年重度卒中偏瘫患者下肢功能恢复的影响。方法符合入组标准的28例下肢本体感觉受累和(或)合并单侧空间忽略的偏瘫患者,分为矫形器组(常规康复治疗的基础上佩戴膝矫形器进行直立体位治疗,14例)和对照组(包括直立位训练的常规康复治疗,14例)2组。分别于训练前和训练后1月采用Fugl-Meyer下肢运动功能评定量表、Brunel平衡量表、Holden步行功能分级、划线试验和改良Barthel指数等对患者的运动、平衡、行走和日常生活能力进行评价。结果 1月后2组间比较,除划线试验、Fugl-Meyer下肢运动功能评定量表评分无显著性差异外,Brunel平衡量表、Holden步行功能量表、改良Barthel指数得分均有显著性差异(P0.05或P0.01),矫形器组疗效明显优于对照组。结论膝控制矫形器对重度老年卒中偏瘫患者下肢功能性活动能力恢复有较好的疗效,可积极推荐使用。

Effect of the knee-controlling orthosis on lower limb function in the quinquagenarian and elderly patients suffering from stroke-induced severe hemiplegics

Objective To investigate the effect of knee-controlling orthosis on lower limb function recovery in thequinquagenarian and elderly patients with stroke suffering from severe hemiplegics. Methods Twenty-eight patients withproprioceptive sense affected and/ or with unilateral spatial neglect after stroke were randomly divided into orthosis groupand control group with 14 cases in each group.All patients received routine rehabilitation therapy in upright position,and thepatients in the orthosis group dressed orthosis while they received standing or walking therapy.Assessment of Fugl-Meyerscale（ FMAL） for affected lower limb, brunel balance assessment（ BBA）, holden functional ambulate classification（FAC）,cancellation task（CT） and modified barthel index（MBI） were carried out before and 1 month after therapy. Results One month later, both groups showed excellent improvement in all items（P〈 0. 05） except CT（P〉 0. 05）. Thescores of BBA,FAC,MBI in the orthosis group were better than those of the control group（P〈0. 05 orP〈0. 01）,while nosignificant difference was found in the score of CT and FMAL（P〉0. 05）. Conclusions Knee-controlling orthosis can im-prove the functional ability of the affected lower limbs in the quinquagenarian and elderly patients with stroke suffering fromsevere hemiplegics.