《中国康复理论与实践》

《中国康复理论与实践》 ›› 2010, Vol. 16 ›› Issue (2): 143-145.

• 论文 • 上一篇    下一篇

胸段完全性脊髓损伤患者的三维步态分析

孙嘉利1，黄东锋2，欧阳亚涛3，毛玉瑢2，钟世镇4   

  1. 1.济南军区青岛第一疗养院，山东青岛市 266071；2.中山医科大学附属第一医院康复医学科，广东广州市 510000；3.广东省工伤康复中心，广东广州市 510970；4.南方医科大学临床解剖研究所，广东广州市 510515。
  • 收稿日期:2009-05-15 修回日期:1900-01-01 出版日期:2010-02-25 发布日期:2010-02-25
  • 通讯作者: 钟世镇

Relationship between Level of Thoracic Complete Spinal Cord Injury and Ambulatory Function with Reciprocating Gait Orthosis through 3D Gait Analysis

SUN Jia-li, HUANG Dong-feng, OUYANG Ya-tao, et al.   

  1. The First Sanatorium of Jinan Command in Qingdao, Qingdao 266071, Shandong; The First Affiliated Hospital, Sun Yan-Sen University, Guangzhou 510000, Guangdong, China
  • Received:2009-05-15 Revised:1900-01-01 Published:2010-02-25 Online:2010-02-25

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摘要： 目的通过对胸段完全性脊髓损伤(TCSCI)患者配戴交互式步行矫形器(RGO)的三维步态分析，比较分析脊髓损伤(SCI)平面与步行能力之间的关系，探讨重建SCI患者步行能力的量化指标。方法选择在本中心住院且配戴RGO进行步行训练3个月以上的TCSCI患者10例，采用Vicon三维步态分析系统进行步态检测与分析。应用Spearman秩和相关系数对TCSCI患者的不同SCI平面与其步态的运动学和时空参数等的相关性进行统计学检验。结果步频和跨步长分别为(37.4±2.15) 步/min和(91.6±9.09) cm；髋关节摆动角度及髋关节伸展和屈曲时相的角速度分别为(42.57 °±5.43 °)、(20.88 °±2.18 °)/s和(124.75 °±9.31 °)/s。步速(r=0.80，P<0.01)、跨步长(r=0.78，P<0.01)、助行架的压力峰值(r=0.82，P<0.01)、髋关节摆动角度(r=0.77，P<0.01)、助行架的压力均值(r=-0.67，P<0.05)和髋关节伸展的角速度(r=0.75，P<0.05)与SCI平面之间均有显著的相关性。结论TCSCI患者双上肢过度负载和髋关节摆动幅度受限是其步行能力受限的主要原因；降低过度负载的康复训练方法有助于改善重建的步行功能。

关键词: 三维步态分析, 脊髓损伤, 运动学, 时空参数, 交互式步行矫形器

Abstract: ObjectiveTo evaluate the relationship between the level of thoracic complete spinal cord injury(SCI) and ambulatory function wearing Reciprocating Gait Orthosis(RGO) through three dimentional gait analysis, and to explore the quantitative indicators of reconstructing walking capacity of thoracic complete SCI patients.Methods10 patients with thoracic complete spinal cord injury of lesion level from T4 to T12 who had experienced RGO gait training for at least 3 months. Three dimentional gait analysis system of Vicon Nexus 1.2 was used to test and examine the gait speed, cadence, stride length, pelvic angle of rotation, hip range of motion(ROM), crutch force, angular velocity of hip flexion and extension phases, etc. Pearson's product moment correlation coefficient and Spearman rank correlation coefficient were used to examine the relationship between the level of spinal cord injury and the kinematic and kinetic values.ResultsThe mean cadence and stride length were (37.4±2.15) steps/min and (91.6±9.09) cm. The mean hip ROM, angular velocity of hip flexion and extension phases were (42.57 °±5.43 °), (20.88 °±2.18 °)/s and (124.75 °±9.31 °)/s respectively. The gait speed, stride length, peak crutch force, hip ROM, mean crutch force and angular velocity of hip extension phase all had significant pertinence with the level of spinal cord injury.ConclusionThe limitation of hip ROM and excessive load of upper limbs mainly result in ambulatory disorder in higher thoracic complete SCI patients who should be undertaken some rehabilitation training to reduce excessive physiological load in order to improve their ambulatory capacity.

Key words: three dimentional gait analysis, spinal cord injury(SCI), kinematics, time-spatial parameter, reciprocating gait orthosis(RGO)