肘腕功能支具对脑卒中偏瘫患者足底压力和平衡功能的效果OA
Effect of elbow-wrist functional orthosis on plantar pressure and balance function in stroke patients with hemiple-gia
目的 探讨佩戴肘腕功能支具对脑卒中偏瘫患者足底压力和平衡功能的效果. 方法 2024年6月至2025年4月,复旦大学附属华山医院和上海禾滨康复医院收治的60例脑卒中偏瘫患者,随机分为对照组(n=30)和观察组(n=30).对照组进行常规神经康复治疗,观察组增加偏瘫侧肘腕功能矫形器辅助训练,共8周.干预前后比较肘关节改良Ashworth量表(MAS)评级、足底压力对称性指数(SI)、足底压力面积和足底平均压强,并采用Berg平衡量表(BBS)、计时起立-行走测试(TUGT)和10米步行试验(10MWT)进行评定. 结果 对照组脱落2例.干预后两组肘关节MAS分级、前足SI、患侧足底压力面积、BBS评分、TUGT和10MWT均明显改善(∣Z∣>3.969,∣t∣>3.528,P<0.01),观察组后足SI和患足平均压强显著改善(∣t∣>4.264,P<0.001);除TUGT和10MWT外,观察组均优于对照组(∣Z∣>2.030,∣t∣>2.096,P<0.05). 结论 肘腕功能支具可通过降低上肢肌张力、调节重心分布和姿势控制,提高脑卒中偏瘫患者平衡功能.
Objective To explore the effect of elbow-wrist functional orthosis on plantar pressure distribution and balance function in stroke patients with hemiplegia. Methods From June,2024 to April,2025,60 patients with post-stroke hemiplegia were recruited from Huashan Hospi-tal,Fudan University,and Shanghai Hebin Rehabilitation Hospital.They were randomly divided into control group(n=30)and intervention group(n=30).The control group received routine neurological rehabilitation,while the intervention group received additional training with an elbow-wrist functional orthosis on the affected side,for eight weeks.Before and after intervention,the Modified Ashworth Scale(MAS)of the elbow joint,plan-tar pressure symmetry index(SI),plantar contact area and mean plantar pressure were recorded,and balance and mobility were assessed using the Berg Balance Scale(BBS),Timed Up&Go Test(TUGT)and 10-Meter Walk Test(10MWT). Results Two cases dropped out in the control group.After treatment,MAS grades of the elbow joint,forefoot SI,affect-ed side plantar pressure area,BBS scores,TUGT and 10MWT of both groups improved(|Z|>3.969,|t|>3.528,P<0.01),while the hindfoot SI and average pressure of the affected foot improved in the intervention group(∣t∣>4.264,P<0.001).Except for TUGT and 10MWT,the intervention group was superior to the control group(∣Z∣>2.030,∣t∣>2.096,P<0.05). Conclusion The elbow-wrist functional orthosis can enhance balance function in stroke patients with hemiplegia by re-ducing upper-limb spasticity,optimizing center-of-gravity distribution,and improving postural control.
吴澄;章云枫;王卫宁;余克威;张艳正;沈嘉蓉;吴毅
上海中医药大学,上海市 201203复旦大学附属华山医院,上海市 200040复旦大学附属华山医院,上海市 200040复旦大学附属华山医院,上海市 200040复旦大学附属华山医院,上海市 200040上海禾滨康复医院,上海市 201702上海禾滨康复医院,上海市 201702
医药卫生
脑卒中偏瘫支具足底压力下肢运动功能
strokehemiplegiaorthosisplantar pressurelower limb motor function
《中国康复理论与实践》 2026 (1)
30-39,10
1.上海市"科技创新行动计划"医学创新研究专项项目(No.22Y31900202No.23Y11906300)2.上海市青浦区卫健委科研课题(No.QWJ2023-62) Supported by Shanghai"Science and Technology Innovation Action Plan"Medical Innovation Research Special Project(No.22Y31900202No.23Y11906300),and Shanghai Qingpu District Health Commission Scientific Research Topic(No.QWJ2023-62)
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