首页|踝关节智能牵伸对脊髓损伤患者下肢痉挛效果的随机对照试验

踝关节智能牵伸对脊髓损伤患者下肢痉挛效果的随机对照试验

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目的 观察踝关节智能柔性牵伸在下肢痉挛脊髓损伤患者中的应用效果.方法 2021年6月至2024年5月,北京博爱医院脊髓损伤患者28例,随机分为对照组和试验组,各14例.两组均接受常规康复治疗,在此基础上,对照组予以手法牵伸治疗,试验组给予踝关节智能牵伸系统训练,共8周.治疗前后分别采用改良Ashworth评定量表(MAS)、踝关节背屈角、临床痉挛指数、腓肠肌内侧头表面肌电最大均方根值和足大趾振动觉阈值(VPT)进行评定.结果 治疗后,试验组MAS分级(χ2=10.378,P=0.035)、踝关节背屈角(Z=-3.306,P<0.001)、临床痉挛指数(t=4.101,P=0.001)和腓肠肌内侧头被动背屈时的最大均方根值(Z=-3.296,P<0.001)均改善,试验组MAS分级(χ2=11.418,P=0.022)、踝关节背屈角(Z=-1.986,P=0.047)、腓肠肌内侧头被动背屈时的最大均方根值(Z=-2.297,P=0.021)均优于对照组.足大趾VPT虽有所改善,但组内和组间比较均无显著性差异(P>0.05).结论 踝关节智能柔性牵伸可改善脊髓损伤患者下肢肌痉挛,有改善足部本体感觉的趋势.
Rehabilitation effect of intelligent ankle stretching on lower extremity spasm in patients with spinal cord injury:a randomized controlled trial
Objective To observe the effect of intelligent flexible ankle stretching training on lower extremity spasm in patients with spinal cord injury.Methods From June,2021 to May,2024,28 patients with spinal cord injury were randomly divided into control group(n=14)and experimental group(n=14).Both groups received conventional rehabilitation treatment.On this ba-sis,the control group received manual extension treatment,and the experimental group received intelligent flexi-ble ankle stretching system training,for eight weeks.The modified Ashworth Scale(MAS),ankle dorsiflexion an-gle,Clinical Spasticity Index(CSI),max root mean square(RMSmax)of surface electromyography of gastrocne-mius medial head and vibration perception threshold(VPT)of great toe were compared.Results After treatment,MAS(χ2=10.378,P=0.035),ankle dorsiflexion angle(Z=-3.306,P<0.001),CSI(t=4.101,P=0.001)and RMSmax of gastrocnemius medial head(Z=-3.296,P<0.001)improved in the experimental group,while MAS(χ2=11.418,P=0.022),ankle dorsiflexion angle(Z=-1.986,P=0.047)and RMSmax of gas-trocnemius medial head(Z=-2.297,P=0.021)were better in the experimental group than in the control group.Although VPT was improved after treatment,no significant difference was found within and beteen groups(P>0.05).Conclusion The intelligent flexible ankle stretching training could improve the lower limb muscle spasticity in patients with spinal cord injury,and may be benefit for foot proprioception.

spinal cord injurylower limb rehabilitation robotspasmrandomized controlled trial

高明明、恽晓萍、赵舒羽、辛然、宋桂芸、赵阳

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首都医科大学康复医学院,北京市 100068

中国康复研究中心北京博爱医院康复评定科,北京市 100068

脊髓损伤 下肢康复机器人 痉挛 随机对照试验

中国康复研究中心青年科研专项基金项目

2021zx-Q9

2024

中国康复理论与实践
中国残疾人康复协会,中国医师协会,中国康复研究中心

中国康复理论与实践

CSTPCD北大核心
影响因子:1.354
ISSN:1006-9771
年,卷(期):2024.30(10)