中国神经再生研究(英文版)

中国神经再生研究(英文版) ›› 2019, Vol. 14 ›› Issue (2): 354-360.doi: 10.4103/1673-5374.244798

• 原著:脊髓损伤修复保护与再生 • 上一篇    下一篇

足底压力板系统对脊髓损伤患者与健康人群步行质量的影响

  

  • 收稿日期:2018-08-06 出版日期:2019-02-15 发布日期:2019-02-15
  • 基金资助:

    中国医科大学圣井医院新技术项目资助，编号：2015-117。

Comparison of walking quality variables between incomplete spinal cord injury patients and healthy subjects by using a footscan plantar pressure system

Xiang-Nan Yuan 1 , Wei-Di Liang 1 , Feng-Hua Zhou 1 , Han-Ting Li 1 , Li-Xin Zhang 1 , Zhi-Qiang Zhang 1 , Jian-Jun Li 2   

  1. 1 Rehabilitation Department, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, China
    2 Department of Orthopedics, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, China
  • Received:2018-08-06 Online:2019-02-15 Published:2019-02-15
  • Contact: Jian-Jun Li, PhD, lij2046@126.com; Zhi-Qiang Zhang, zhangzq@sj-hospital.org.
  • Supported by:

    This study was supported by the New Technique Project of Shengjing Hospital of China Medical University, China, No. 2015-117 (to XNY).

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摘要：

脊髓损伤后恢复步行能力并提高步行质量是脊髓康复的主要目标，通过足底压力分析系统可以获取步行的时间空间参数及足底压力压强参数，有研究发现双侧损伤的脊髓损伤患者存在步长的不对称性，然而脊髓损伤患者是否存在其他参数的不对称性未见报道。试验为前瞻性、横断面研究，纳入51例受试者，脊髓损伤患者23例，年龄(48.1±14.5)岁，女13例，男10例；健康人28例，年龄(47.1±9.8)岁，女16例，男12例。全部受试者要求在足底压力测量设备上进行裸足步行，测量步行速度及时间-空间参数(包括步行周期，支撑相时间，支撑相百分比，步长等)。结果发现：(1)与健康人比较，脊髓损伤患者的步行速度下降，步行周期延长，支撑相时间增加，支撑相百分比增加，但步长减少；(2)试验对受试者足底进行分区，测量各个分区部位的足底压力参数，同时进行双侧对称性比较发现，与健康人比较，脊髓损伤患者的跖骨、足趾部位的足底分区部位最大压强显著下降，足跟区域(足跟内侧，足跟外侧)的区域冲量百分比及触底面积百分比均增加；(3)脊髓损伤患者步长、支撑相、最大力、冲量、触底面积的对称性指数均增加，提示对称性下降；(4)上述结果显示，脊髓损伤患者的步行质量，包括时间空间参数，足底压力压强参数，对称性指数等均较健康人下降。足底压力参数及对称性指数可作为脊髓损伤患者步行质量改变的敏感性量化指标；(5)试验已在英国临床试验注册中心注册(注册号：注册号ISRCTN42544587，注册时间：2018-08-22)，注册方案版本号1.0。

orcid: 0000-0002-0883-673X (Jian-Jun Li)
           0000-0001-7610-2722 (Zhi-Qiang Zhang)

关键词: 脊髓损伤, 步行, 步行质量, 足底压力系统, 足底压力分区, 速度, 足底压强, 冲量, 触地面积, 对称性指数, 神经再生

Abstract:

The main goal of spinal cord rehabilitation is to restore walking ability and improve walking quality after spinal cord injury (SCI). The spatiotemporal parameters of walking and the parameters of plantar pressure can be obtained using a plantar pressure analysis system. Previous studies have reported step asymmetry in patients with bilateral SCI. However, the asymmetry of other parameters in patients with SCI has not been reported. This was a prospective, cross-sectional study, which included 23 patients with SCI, aged 48.1 ± 14.5 years, and 28 healthy subjects, aged 47.1 ± 9.8 years. All subjects underwent bare foot walking on a plantar pressure measurement device to measure walking speed and spatiotemporal parameters. Compared with healthy subjects, SCI patients had slower walking speed, longer stride time and stance time, larger stance phase percentage, and shorter stride length. The peak pressures under the metatarsal heads and toe were lower in SCI patients than in healthy subjects. In the heel, regional impulse and the contact area percentage in SCI patients were higher than those in healthy subjects. The symmetry indexes of stance time, step length, maximum force, impulse and contact area were increased in SCI patients, indicating a decline in symmetry. The results confirm that the gait quality, including spatiotemporal variables and plantar pressure parameters, and symmetry index were lower in SCI patients compared with healthy subjects. Plantar pressure parameters and symmetry index could be sensitive quantitative parameters to improve gait quality of SCI patients. The protocols were approved by the Clinical Research Ethics Committee of Shengjing Hospital of China Medical University (approval No. 2015PS54J) on August 13, 2015. This trial was registered in the ISRCTN Registry (ISRCTN42544587) on August 22, 2018. Protocol version: 1.0.

Key words: nerve regeneration, spinal cord injury, walking, gait quality, plantar pressure system, plantar pressure distribution, speed, plantar pressure, impulse, contact area, symmetry index, neural regeneration