1.南京中医药大学附属南京市中医院脑病科(江苏 南京 210001)
陈骋,男,康复治疗师,主要从事中西医结合康复科临床研究工作
张敬华,博士,副主任医师;E-mail: zjh2013zjh@126.com
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陈骋, 张敬华, 陆建虎. 基于三维步态分析研究太极步法对缺血性脑卒中后偏瘫患者步行能力的影响[J]. 上海中医药杂志, 2021,55(3):50-53.
Cheng CHEN, Jinghua ZHANG, Jianhu LU. Clinical study on effect of Tai Chi footwork on walking ability of hemiplegic patients following ischemic stroke based on three-dimensional gait analysis[J]. Shanghai Journal of Traditional Chinese Medicine, 2021,55(3):50-53.
陈骋, 张敬华, 陆建虎. 基于三维步态分析研究太极步法对缺血性脑卒中后偏瘫患者步行能力的影响[J]. 上海中医药杂志, 2021,55(3):50-53. DOI: 10.16305/j.1007-1334.2021.2006144.
Cheng CHEN, Jinghua ZHANG, Jianhu LU. Clinical study on effect of Tai Chi footwork on walking ability of hemiplegic patients following ischemic stroke based on three-dimensional gait analysis[J]. Shanghai Journal of Traditional Chinese Medicine, 2021,55(3):50-53. DOI: 10.16305/j.1007-1334.2021.2006144.
目的,2,从三维步态分析的角度观察太极步法对缺血性脑卒中后偏瘫患者步行能力的影响。,方法,2,将60例缺血性脑卒中后偏瘫患者随机分为对照组和试验组,每组30例。对照组采用常规康复训练,试验组采用太极步法训练。两组疗程均为30 d,运用全身三维步态与运动分析系统检测评估患者的运动学时间参数、空间参数。,结果,2,①试验过程中,无病例脱落。②治疗前后组内比较,试验组步幅时间缩短,健侧支撑相占比减少,健侧摆动相占比增加(,P,<,0.05),患侧支撑相、患侧摆动相占比差异无统计学意义(,P,>,0.05);对照组步幅时间缩短,健侧支撑相占比减少、健侧摆动相占比增加,患侧支撑相占比增加、患侧摆动相占比减少(,P,<,0.05)。组间治疗后比较,试验组步幅时间明显短于对照组,患侧支撑相占比明显小于对照组,患侧摆动相占比明显大于对照组(,P,<,0.05);两组健侧支撑相、健侧摆动相占比差异无统计学意义(,P,>,0.05)。③治疗前后组内比较,试验组步幅加长,步速加快,步宽缩短,健足步长加长,患足步长加长(,P,<,0.05);对照组步幅加长,步速加快,步宽缩短,患足步长加长(,P,<,0.05),健足步长差异无统计学意义(,P,>,0.05)。组间治疗后比较,试验组步幅明显长于对照组,步速明显快于对照组,步宽明显短于对照组(,P,<,0.05);两组健足步长、患足步长差异无统计学意义(,P,>,0.05)。,结论,2,与常规康复训练相比,太极步法能更明显地改善缺血性脑卒中后偏瘫患者的整体步行能力,提高患侧下肢支撑能力及摆动能力。
Objective,2,To observe the effect of Tai Chi footwork on walking ability of hemiplegic patients following ischemic stroke based on three-dimensional gait analysis.,Methods,2,Sixty patients with hemiplegia after ischemic stroke were randomly divided into control group (,n,=30) and experimental group (,n,=30). The control group received conventional rehabilitation training, while the experimental group received standardized Tai Chi footwork training. The course of treatment in both groups was 30 days. The three-dimensional gait and motion analysis system was used to detect and evaluate patients’ kinematic parameters of time and space variables.,Results,2,①There was no drop-out case during the trail. ②In the experimental group, the stride time was shortened, the proportion of supporting phase of the healthy side reduced, and the proportion of swinging phase of the healthy side increased after treatment (,P,<,0.05), while there was no significant difference in the proportion of supporting phase and swinging phase of affected side before and after treatment(,P,>,0.05). In the control group, the stride time was shortened, the proportion of supporting phase of the healthy side reduced, the proportion of swinging phase of the healthy side increased, the proportion of supporting phase of the affected side increased, and the proportion of swinging phase of the affected side reduced after treatment(,P,<,0.05). After treatment, the stride time in the experimental group was significantly shorter than that in the control group, the proportion of supporting phase of the affected side was significantly lower than that in the control group, and the proportion of swinging phase of the affected side was significantly higher than that in the control group (,P,<,0.05). There was no significant difference in the proportion of supporting phase and swinging phase of healthy side between the two groups after treatment (,P,>,0.05). ③In the experiment group, the stride length was lengthened, the stride speed was accelerated, the stride width was shortened, and the step length of healthy and affected foot was lengthened after treatment (,P,<,0.05). In the control group, the stride length was lengthened, the stride speed was accelerated, the stride width was shortened, the step length of affected foot was lengthened (,P,<,0.05), and there was no significant difference in the step length of healthy foot before and after treatment (,P,>,0.05). After treatment, the stride length of the experimental group was significantly longer than that of the control group, the stride speed was significantly faster than that of the control group, and the stride width was significantly shorter than that of the control group (,P,<,0.05). There was no significant difference in the step length of healthy foot and affected foot between the two groups (,P,>,0.05).,Conclusion,2,Compared with conventional rehabilitation training, Tai Chi footwork training can significantly improve the overall walking ability of hemiplegic patients following ischemic stroke, and improve the supporting and swinging ability of the affected lower limbs.
太极拳太极步法缺血性脑卒中偏瘫步态分析康复训练
TaijiquanTai Chi footworkischemic strokehemiplegiagait analysisrehabilitation training
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