膝踝足矫形器对完全性脊髓损伤患者的康复作用
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摘要
目的探讨膝踝足矫形器(KAFO)对完全性脊髓损伤患者的康复作用。方法 L1及以下脊髓损伤患者17例,其中男性11例,女性6例;损伤节段:L1损伤9例,L2损伤5例,L3损伤3例;年龄19~42岁,平均34.7岁。在装配膝踝足矫形器前需进行多项康复治疗,包括肌肉力量、心肺功能、轮椅转移、日常活动能力(ADL)、膀胱训练等,装配矫形器后加强步态训练;分别于矫形器装配前及出院前进行限时的步行功能检查(包括6min步行评测和10m步行时间评测)、步态分析及改良Barthel指数(MBI)作为指标进行评定。结果 17例患者在不使用矫形器的情况下均不能独立行走,矫形器装配及训练后10m步行时间平均(76.35±32.45)s,6min步行距离平均为(67.48±24.35)m,平均步长37.9cm。结论步行矫形器配合系统的康复治疗对改善完全性脊髓损伤患者步行能力及日常活动能力效果理想。
Objective To investigate effect of knee ankle foot orthosis (KAFO) in the rehabilitation of patients with complete spinal cord injury. Methods Seventeen patients (11 males and 6 females) with spinal cord injury of L 1 or under L 1 were enrolled in the study, aged from 19 to 42 years old (34.7 in average), of which 9 cases were L 1 level, 5 cases were L 2 level, 3 cases were L 3 level. Several rehabilitation therapies were needed before assembly of KAFO, including muscle strength, cardiopulmonary function, wheelchair transfer, the activities daily living (ADL), bladder training. After assembly of KAFO, intensive gait training was performed, with walking function tests (including 6 min walking test and 10 m walking time evaluation) before orthosis assembly and before discharge. The gait analysis and the modified Barthel index (MBI) were evaluated. Results All patients could not walk independently without orthosis conditions. After the orthosis assembly and training, the 10 m walking time was (76.35±32.45) s, the average 6 min walking distance was (67.48 ± 24.35) m, and the average step size was 37.9 cm. Conclusion The KAFO combined with systematic rehabilitation treatment can improve the walking ability and the activities of daily living in patients with complete spinal cord injury.
Objective To investigate effect of knee ankle foot orthosis (KAFO) in the rehabilitation of patients with complete spinal cord injury. Methods Seventeen patients (11 males and 6 females) with spinal cord injury of L 1 or under L 1 were enrolled in the study, aged from 19 to 42 years old (34.7 in average), of which 9 cases were L 1 level, 5 cases were L 2 level, 3 cases were L 3 level. Several rehabilitation therapies were needed before assembly of KAFO, including muscle strength, cardiopulmonary function, wheelchair transfer, the activities daily living (ADL), bladder training. After assembly of KAFO, intensive gait training was performed, with walking function tests (including 6 min walking test and 10 m walking time evaluation) before orthosis assembly and before discharge. The gait analysis and the modified Barthel index (MBI) were evaluated. Results All patients could not walk independently without orthosis conditions. After the orthosis assembly and training, the 10 m walking time was (76.35±32.45) s, the average 6 min walking distance was (67.48 ± 24.35) m, and the average step size was 37.9 cm. Conclusion The KAFO combined with systematic rehabilitation treatment can improve the walking ability and the activities of daily living in patients with complete spinal cord injury.
引文
[1]高怀民,瓮长水,于增志.重度脑卒中偏瘫早期的下肢支具治疗[J].中国康复医学杂志,1999,14(5):221.
[2]赵正金,黄杰,陆敏,等.截瘫患者装配行走器后的训练与日常生活活动能力分析[J].中华物理医学与康复杂志,2003,25(3):172-124.
[3]武继祥,周贤丽,刘宏亮,等.新型互动式截瘫行走器在截瘫患者中的应用[J].中华物理医学与康复杂志,2003,25(8):480-482.
[4]刘四文,刘海兵,唐丹.矫形器结合功能训练改善患者步行能力[J].中国康复理论与实践,2003,9(12):707-708.
[5]廖哲安,欧阳亚涛,唐丹.下肢矫形器对脊髓损伤患者ADL和行走能力的影响分析[J].中国康复医学杂志,2004,19(7):502-503.
[6]唐丹,刘四文,刘海兵.不同步行矫形器在下胸段脊髓损伤中的应用探讨[J].中国康复医学杂志,2004,19(8):572-573.
[7]苏强,赵正全.新型截瘫行走器在临床中的应用[J].中国康复,2001,16(3):176-177.
[8]高怀民.使用助行器械和矫形器步行训练的最新进展[J].现代康复,2000,4(7):315-317.
[9]黄杰,黄晓琳,陈勇.康复治疗对脊髓损伤患者功能恢复的影响[J].中华物理医学与康复杂志,2003,25(11):679-700.
[10]尤春景,黄杰,黄国荣.步行矫形器在截瘫患者康复中的应用[J].中华物理医学与康复杂志,2002,24(1):435-436.
[11]梁红英,侯树勋,陆耘.应用往复式截瘫步行器重建完全性截瘫患者的步行功能[J].中华创伤骨科杂志,2004,6(3):319-322.
[2]赵正金,黄杰,陆敏,等.截瘫患者装配行走器后的训练与日常生活活动能力分析[J].中华物理医学与康复杂志,2003,25(3):172-124.
[3]武继祥,周贤丽,刘宏亮,等.新型互动式截瘫行走器在截瘫患者中的应用[J].中华物理医学与康复杂志,2003,25(8):480-482.
[4]刘四文,刘海兵,唐丹.矫形器结合功能训练改善患者步行能力[J].中国康复理论与实践,2003,9(12):707-708.
[5]廖哲安,欧阳亚涛,唐丹.下肢矫形器对脊髓损伤患者ADL和行走能力的影响分析[J].中国康复医学杂志,2004,19(7):502-503.
[6]唐丹,刘四文,刘海兵.不同步行矫形器在下胸段脊髓损伤中的应用探讨[J].中国康复医学杂志,2004,19(8):572-573.
[7]苏强,赵正全.新型截瘫行走器在临床中的应用[J].中国康复,2001,16(3):176-177.
[8]高怀民.使用助行器械和矫形器步行训练的最新进展[J].现代康复,2000,4(7):315-317.
[9]黄杰,黄晓琳,陈勇.康复治疗对脊髓损伤患者功能恢复的影响[J].中华物理医学与康复杂志,2003,25(11):679-700.
[10]尤春景,黄杰,黄国荣.步行矫形器在截瘫患者康复中的应用[J].中华物理医学与康复杂志,2002,24(1):435-436.
[11]梁红英,侯树勋,陆耘.应用往复式截瘫步行器重建完全性截瘫患者的步行功能[J].中华创伤骨科杂志,2004,6(3):319-322.