早期使用前置式踝足矫形器脑卒中偏瘫患者的步行能力和速度

背景：脑损伤和脑卒中存活者有相当部分遗留有足下垂内翻畸形,需要借助于踝足矫形器进行治疗。 目的：探讨早期使用前置式踝足矫形器对脑卒中偏瘫患者步行功能的影响及优势。 方法：回顾分析常熟市第二人民医院2008年6月至2009年10月治疗的54例脑卒中偏瘫患者的临床资料,佩戴前置式踝足矫形器为前置组28例和佩戴后置式踝足矫形器为后置组26例。所有患者进行10 m最大步行速度测试,每天观察两组患者步行功能恢复情况。 结果与结论：所有患者在观察期间,无退出及死亡,前置式踝足矫形器组日常生活能力的Barthel指数评分(60.0±12.9)明显高于后置踝足矫形器组日常生活能力的Barthel指数评分(59.1±10.9),但两组间没有显著差异(P > 0.05),在10 m最大步行速度测试中,前置式踝足矫形器组步行速度(39.6±11.6) m/min较后置踝足矫形器组步行速度(33.0±12.4) m/min明显加快(P < 0.05)。说明前置式踝足矫形器更合适用于脑卒中偏瘫患者改善步行速度。

Early application of front-ankle-foot orthosis affects the walking ability and speed of the patients with hemiplegia after stroke

BACKGROUND:Most of the traumatic brain injury and stroke survivors have foot drop and varus deformity, that need to be treated with ankle-foot orthosis. OBJECTIVE:To investigate the advantages and effect of early application of front-ankle-foot orthosis on the walking function of the patients with hemiplegia after stroke. METHODS:The clinical data of 54 patients with hemiplegia after stroke treated in the Changshu No. 2 People’s Hospital from June 2008 to October 2009 were retrospectively analyzed. The patients treated with front-ankle-foot orthosis were the front group (n=28), and the patients treated with rear-ankle-foot orthosis were the rear group (n=26). All the patients received 10 m maximum walking speed test, and the recovery of walking function of the patients in two groups were observed daily. RESUTLS AND CONCLUSION:There were no patients exited and dead in the observation period. The activities of daily living Barthel index in the front-ankle-foot orthoses group (60.0±12.9) was significantly higher than that  in the rear-ankle-foot orthoses group (59.1±10.9), and there was no significant difference in the activities of daily living Barthel index between two groups (P > 0.05). For the 10 m maximum walking speed test, the walking speed of (39.6±11.6) m/min in the front-ankle-foot orthosis group was significantly faster than that of (33.0±12.4) m/min in the rear-ankle-foot orthosis group (P < 0.05). Front-ankle-foot orthosis is more appropriate for patients with hemiplegia after stroke to improve the walking speed.