矫形弹力绷带对痉挛性偏瘫脑性瘫痪患儿步态对称性和步行能力的效果

doi:10.3969/j.issn.1006-9771.2023.09.012

《中国康复理论与实践》 ›› 2023, Vol. 29 ›› Issue (9): 1083-1089.doi: 10.3969/j.issn.1006-9771.2023.09.012

矫形弹力绷带对痉挛性偏瘫脑性瘫痪患儿步态对称性和步行能力的效果

胡晓诗¹^,², 张琦¹^,²(), 岳青¹^,², 梁艳华¹^,², 李晓松¹^,², 冯啊美², 张燕庆²

1.首都医科大学康复医学院，北京市 100068
2.中国康复研究中心北京博爱医院物理疗法科，北京市 100068

收稿日期:2023-07-27 修回日期:2023-08-07 出版日期:2023-09-25 发布日期:2023-10-26
通讯作者: 张琦 E-mail:13501320729@163.com
作者简介:胡晓诗(1987-)，女，汉族，山西大同市人，硕士，主管技师，主要研究方向：儿童康复。
基金资助:
中国康复研究中心青年基金项目(2020-Q2)

Effect of orthopedic elastic bandages on gait symmetry and walking ability in children with spastic hemiplegic cerebral palsy

HU Xiaoshi¹^,², ZHANG Qi¹^,²(), YUE Qing¹^,², LIANG Yanhua¹^,², LI Xiaosong¹^,², FENG Amei², ZHANG Yanqing²

1. Capital Medical University School of Rehabilitation Medicine, Beijing 100068, China
2. Department of Physiotherapy, Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing 100068, China

Received:2023-07-27 Revised:2023-08-07 Published:2023-09-25 Online:2023-10-26
Contact: ZHANG Qi E-mail:13501320729@163.com
Supported by:
China Rehabilitation Research Center Youth Fund(2020-Q2)

摘要/Abstract

摘要：

目的观察矫形弹力绷带改善痉挛性偏瘫脑瘫患儿步态对称性和步行能力的短期疗效。

方法 2020年6月至2023年6月，北京博爱医院痉挛性偏瘫脑瘫患儿31例，随机分为对照组(n = 15)和试验组(n = 16)。两组均接受常规康复治疗，此外，对照组采用常规步行训练，试验组佩戴矫形弹力绷带进行步行训练，共4周。训练前后，计算足偏角比(患侧足偏角/健侧足偏角)、步长比(患侧步长/健侧步长)、步态线长比(患侧步态线长/健侧步态线长)和站立阶段比(患侧站立阶段百分比/健侧站立阶段百分比)；测量步宽和10米步行测试(10MWT )速度。

结果试验组脱落1例。训练后，两组足偏角比、步长比、步态线长比和站立阶段比均改善(|t| > 2.434, P < 0.05)，且试验组优于对照组(|t| > 2.230, P < 0.05)；两组10MWT自选速度和最大速度均显著提高(|t| > 9.186, P < 0.001)，且试验组高于对照组(|t| > 2.278, P < 0.05)。

结论佩戴矫形弹力绷带训练能有效改善痉挛性偏瘫脑瘫患儿的步态对称性和步行能力。

关键词: 脑性瘫痪, 痉挛性偏瘫, 步行, 矫形弹力绷带, 步态对称性

Abstract:

Objective To investigate the short-term efficacy of orthopedic elastic bandages on gait symmetry and walking ability in children with spastic hemiplegic cerebral palsy.

Methods From June, 2020 to June, 2023, 31 children with spastic hemiplegic cerebral palsy from Beijing Bo'ai Hospital were randomly divided into control group (n = 15) and experimental group (n = 16). Both groups received routine rehabilitation, while the control group received routine walking training, and the experimental group wore an orthopedic elastic bandage for walking training, for four weeks. The indexes of gait symmetry of foot deviation angle ratio (affected/healthy), step length ratio (affected/healthy), gait line ratio (affected/healthy) and standing stage ratio (affected percentage/healthy percentage) were calculated before and after training, and they were measured step width and the optional and maximum walking speed of 10-meter walk test (10MWT).

Results One case dropped off in the experimental group. After training, the foot deviation ratio, step length ratio, gait line ratio, and standing stage ratio improved in both groups (|t| > 2.434, P < 0.05), and they were better in the experimental group than in the control group (|t| > 2.230, P < 0.05); while the optional and maximum walking speed of 10MWT improved in both groups (|t| > 9.186, P < 0.001), and they were better in the experimental group than in the control group (|t| > 2.278, P < 0.05).

Conclusion Wearing orthopedic elastic bandages during rehabilitation can promote the gait symmetry and walking ability of children with spastic hemiplegic cerebral palsy.

Key words: cerebral palsy, spastic hemiplegia, walking, orthopedic elastic bandage, gait symmetry

中图分类号:

R742.3

胡晓诗, 张琦, 岳青, 梁艳华, 李晓松, 冯啊美, 张燕庆. 矫形弹力绷带对痉挛性偏瘫脑性瘫痪患儿步态对称性和步行能力的效果[J]. 《中国康复理论与实践》, 2023, 29(9): 1083-1089.

HU Xiaoshi, ZHANG Qi, YUE Qing, LIANG Yanhua, LI Xiaosong, FENG Amei, ZHANG Yanqing. Effect of orthopedic elastic bandages on gait symmetry and walking ability in children with spastic hemiplegic cerebral palsy[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(9): 1083-1089.

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组别	n	性别(男/女)/n^a	年龄/岁^b	偏瘫侧(左/右)/n^a	GMFCS分级(I/II)/n^a
对照组	15	13/2	3.87±1.13	7/8	12/3
试验组	16	13/3	3.75±0.93	7/9	15/1
Z值		-	-0.108	-	-
P值		1.000	0.914	1.000	0.333

组别	n	训练前	训练后	t值	P值
对照组	15	3.70±1.07	3.44±0.92	2.801	0.014
试验组	15	3.71±1.22	2.01±0.58	7.929	< 0.001
t值		-0.038	5.101
P值		0.970	< 0.001

组别	n	训练前	训练后	t值	P值
对照组	15	1.34±0.16	1.30±0.14	3.057	0.009
试验组	15	1.35±0.15	1.20±0.08	5.867	< 0.001
t值		-0.172	2.230
P值		0.865	0.036

组别	n	训练前	训练后	t值	P值
对照组	15	0.47±0.20	0.49±0.17	-2.434	0.029
试验组	15	0.50±0.17	0.67±0.14	-12.094	< 0.001
t值		-0.498	-3.190
P值		0.623	0.003

组别	n	训练前	训练后	t值	P值
对照组	15	0.83±0.03	0.84±0.03	-3.384	0.004
试验组	15	0.82±0.05	0.88±0.04	-7.063	< 0.001
t值		0.616	-3.032
P值		0.543	0.005

矫形弹力绷带对痉挛性偏瘫脑性瘫痪患儿步态对称性和步行能力的效果

Effect of orthopedic elastic bandages on gait symmetry and walking ability in children with spastic hemiplegic cerebral palsy

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组别	n	训练前	训练后	t值	P值
对照组	15	12.47±2.50	12.13±1.92	1.323	0.207
试验组	15	13.27±2.19	12.80±1.37	1.606	0.131
t值		-0.932	-1.093
P值		0.359	0.284

组别	n	训练前	训练后	t值	P值
对照组	15	0.71±0.15	0.85±0.16	-11.549	< 0.001
试验组	15	0.72±0.20	1.01±0.21	-9.186	< 0.001
t值		-0.103	-2.278
P值		0.919	0.031

组别	n	训练前	训练后	t值	P值
对照组	15	0.94±0.17	1.18±0.24	-9.331	< 0.001
试验组	15	0.99±0.20	1.37±0.22	-14.260	< 0.001
t值		-0.771	-2.321
P值		0.447	0.028

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