脑卒中偏瘫患者步行速度临床决定因素的分析

目的 判别决定脑卒中偏瘫患者步行速度最重要的临床变量。方法 32例恢复步行能力的脑卒中偏瘫患者，测定在自然舒适状态下的10m步行速度，用Fug1—Meyer评价法评测下肢运动功能，用Motricity指数评测下肢肌力，用Berg平衡量表评定平衡功能，用改良Ashworth评定法评定足跖屈肌张力。对步行速度和临床变量进行Pearson相关分析，然后进行逐步回归分析。结果 患者的步行速度与下肢运动功能、平衡功能和下肢肌力之间呈高度正相关(r＝0．781—0．834，P＜0．001)；下肢运动功能与步行速度之间的相关性更高(r＝0．834)；步行速度与足跖屈肌张力痉挛程度呈负相关(r＝-0．461，P＜0．05)。进一步回归分析分析发现，下肢运动功能对步行速度有显著性影响(R^2＝0．696，P＜0．001)。结论 下肢运动功能是决定脑卒中偏瘫患者步行速度最重要的临床因素。

Analysis of the clinical factors determining walking speed in hemiparetic stroke patients

ObjectiveTo analyse the most important clinical variables determining walking speed in hemiparetic stroke patients.MethodsThirty-two stroke subjects were able to walk independently in the study.The freely chosen speed was determined by using 10m walking speed test.The motor function,strength of the paretic lower limb,and the balance were evaluated with the Fugl-Meyer Assessment, Motricity Index,and Berg Balance Scale.Modified Ashworth Scale was used to assess the muscle tone of the plantarflexors.The level of association between walking speed and the clinical variables were examined with Pearson's correlation coefficients and by multiple linear regression analysis by using the stepwise method.ResultsThe motor function,strength of the lower limb and the balance were significantly positive related to walking speed(r=0.781-0.834,P<0.001),and the muscle tone of the plantarflexor was moderate negative related to walking speed(r=-0.461,P<0.05).The regression analysis selected motor function of the lower limb as a significant variable(R 2=0.696,P<0.001).ConclusionsThe motor function of the lower limb is the important clinical factor to determine the walking speed of stroke subjects.