踝足关节“8”字绷带对脑卒中后偏瘫患者步态的影响

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目的:研究“8”字绷带对偏瘫患者步态的影响。方法:将56例脑卒中偏瘫患者随机分为观察组28例和对照组28例,对照组患者采用运动再学习、Bobath技术为主的康复训练,观察组每日采用与对照组相同的训练方法,并在步行训练时使用弹力绷带20分钟。2组患者均于治疗前、后采用改良的Barthel指数(modified Barthel index,MBI)、Holden步行功能分级、10m最大步行速度分别评定患者的日常生活能力、步行功能、最大步行速度,同时采取足印法、摄像分析法对受试者进步态分析。结果:观察组患者使用“8”字绷带后,静止时踝关节背屈角度明显改善,由之前的平均-8.91±6.11°增至5.23±4.11°,足外翻角度平均由-15.22±5.12°增至2.52±2.34°。步行周期中摆动相踝关节背屈角度明显提高,触地初期踝关节背屈足跟着地。跨步长、步速明显提高,其中跨步长由0.47±0.18m增加至0.59±0.12m,步速由0.61±0.1,3m/s增加至0.78±0.08m/s。治疗后,2组患者Barthel指数、Holden步行功能分级、10m最大步行速度较组内治疗前有显著改善,差异有统计学意义(P<0.05)。治疗后观察组各项指标改善情况均显著优于对照组,差异有统计学意义(P<0.05)。结论:“8”字绷带可以明显改善偏瘫患者踝足关节下垂、内翻的程度从而改善步态及步行能力。 Objective: To study the effect of “8 ” bandages on the gait of patients with hemiplegia. Methods: Fifty-six stroke patients with hemiplegia were randomly divided into observation group (n = 28) and control group (n = 28). The control group was rehabilitated by exercise and Bobath technique. The observation group received the same training method as the control group , And use stretch bandages for 20 minutes while walking. The patients in both groups were evaluated with modified Barthel index (MBI), Holden walk function grading and maximum walk speed of 10 m before and after treatment to evaluate their daily living ability, walking function and maximum walking speed, Method, video analysis of the subjects progress of state analysis. Results: The angle of ankle dorsal flexion increased significantly from -8.91 ± 6.11 ° to 5.23 ± 4.11 ° in the observation group after using “8” bandage. The mean value of the foot valgus was -15.22 ± 5.12 ° to 2.52 ± 2.34 °. During the walking cycle, the dorsiflexion angle of the ankle joint obviously increases, and the ankle dorsiflexion followed the ground in the initial touchdown. The stride length and pace speed increased obviously. The stride length increased from 0.47 ± 0.18m to 0.59 ± 0.12m, and the pace increased from 0.61 ± 0.1,3m / s to 0.78 ± 0.08m / s. After treatment, Barthel index, Holden walking grading, maximum walking speed of 10m were significantly improved in two groups (P <0.05). After treatment, the observation group improved significantly all the indicators than the control group, the difference was statistically significant (P <0.05). Conclusion: “8 ” bandages can significantly improve the degree of ptosis and varus of ankle-foot joints in patients with hemiplegia to improve gait and walking ability.
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