中国神经再生研究(英文版) ›› 2016, Vol. 11 ›› Issue (12): 1997-2003.doi: 10.4103/1673-5374.197144

• 原著:脊髓损伤修复保护与再生 • 上一篇    下一篇

截瘫步行矫形器在胸腰椎脊髓损伤患者治疗过程中的应用

  

  • 收稿日期:2016-11-20 出版日期:2016-12-31 发布日期:2016-12-31

Application of a paraplegic gait orthosis in thoracolumbar spinal cord injury

Lang Shuai, Guo-hua Yu, Zhen Feng*, Wan-song Wang, Wei-ming Sun, Lu Zhou, Yin Yan   

  1. Department of Rehabilitation, the First Afliated Hospital of Nanchang University, Nanchang, Jiangxi Province, China
  • Received:2016-11-20 Online:2016-12-31 Published:2016-12-31
  • Contact: Zhen Feng, fengzhenly@sina.com.

摘要:

已有研究证实截瘫行走支具可帮助胸腰椎脊髓损伤后截瘫患者站立和步行,然而如何针胸腰椎脊髓损伤患者配备相应的个体化截瘫矫形器以改善患者的日常生活自理能力是目前研究的主要难题。我们将T4节段及以下脊髓损伤患者36例随机分为观察组和对照组,每组18例。对照组进行关节活动度维持、残存肌力训练、站立训练、平衡功能训练、功能性电刺激综合性的系统康复治疗;观察组在综合性的系统康复治疗基础上,按不同脊髓损伤平面残余双下肢关键肌的肌力大小,装配不同的截瘫行走支具并进行功能训练。经过3个月的康复训练发现,观察组18例患者装配截瘫行走支具训练后,达到治疗性步行8例,家庭性步行7例,社区性步行3例,而对照组尚未发现有步行能力的患者。结果说明,装配个体化截瘫支具,对胸腰椎脊髓损伤患者的日常生活自理能力及步行能力的改善有重要意义。 

orcid: 0000-0002-6268-2516 (Zhen Feng)

关键词: 神经再生, 脊髓损伤, 截瘫支具, 胸腰椎, 步行功能, 日常生活自理能力, 步行功能, 复式步态矫形器, 髋膝踝足矫形器, 膝踝足矫形器, 踝足矫形器

Abstract: Paraplegic gait orthosis has been shown to help paraplegic patients stand and walk, although this method cannot be individualized for patients with different spinal cord injuries and functional recovery of the lower extremities. Tere is, however, a great need to develop individualized paraplegic orthosis to improve overall quality of life for paraplegic patients. In the present study, 36 spinal cord (below T4) injury patients were equally and randomly divided into control and observation groups. Te control group received systematic rehabilitation training, including maintenance of joint range of motion, residual muscle strength training, standing training, balance training, and functional electrical stimulation. Te observation group received an individualized paraplegic locomotion brace and functional training according to the various spinal cord injury levels and muscle strength based on comprehensive systematic rehabilitation training. Afer 3 months of rehabilitation training, the observation group achieved therapeutic locomotion in 8 cases, family-based locomotion in 7 cases, and community-based locomotion in 3 cases. However, locomotion was not achieved in any of the control group patients. Tese fndings suggest that individualized paraplegic braces signifcantly improve activity of daily living and locomotion in patients with thoracolumbar spinal cord injury.

Key words: nerve regeneration, spinal cord injury, paraplegia brace, thoracolumbar spine, locomotion ability, activity of daily living, reciprocating gait orthosis, hip-knee ankle foot orthosis, knee-ankle foot orthosis, ankle foot orthosis, neural regeneration