脑卒中足下垂患者摆动相骨盆运动特征分析

关键词：脑卒中  足下垂  骨盆  相关性分析

Keywords:stroke  foot drop  pelvis  correlation analysis

摘要：

      摘要 目的：研究脑卒中足下垂患者摆动相骨盆运动特征，探讨骨盆代偿机制。 方法：选取脑卒中足下垂患者30例作为试验组，30例健康者作为对照组，按照与试验组偏瘫侧、非偏瘫侧左右一致、性别相同的原则，将对照组左右侧数据分为对照组1、对照组2。运用三维步态分析系统采集、分析试验组和对照组的时空参数及摆动相骨盆、踝关节运动学参数，并对偏瘫侧骨盆与踝关节角度进行相关性分析。 结果：与非偏瘫侧比较：偏瘫侧步频、支撑期百分比减小，骨盆最大后倾、旋前角减小，最大旋后、向上侧倾角增大，矢状面、冠状面、横断面关节活动度（ROM）均增大，最大踝背屈减小、最大踝跖屈增大（均P＜0.05）。与对照组1比较：偏瘫侧步长缩短，步速减慢，步频降低，支撑相百分比延长，骨盆最大前倾、旋后、向上侧倾角及矢状面、横断面ROM均增大，最大旋前、向下侧倾角减小，同时踝关节最大背屈角减小，踝关节ROM减小（均P＜0.05）。与对照组2比较：非偏瘫侧步长缩短、步速减慢、步频降低、支撑期百分比延长，骨盆最大前、后倾角增大，横断面、冠状面ROM均减小，踝关节最大跖屈角及ROM减小（均P＜0.05）。偏瘫侧骨盆旋转与最大踝背屈、踝跖屈均有明显负相关（均P＜0.05）；骨盆侧倾与最大踝跖屈明显负相关（均P＜0.05）。 结论：脑卒中足下垂患者摆动相骨盆运动特征显著，骨盆与踝关节运动存在相关性且同时受其他关节的影响。

Abstract:

      Abstract Objective：To study the characteristics of pelvic movement in swing phase of stroke patients with foot drop and to explore the mechanism of pelvic compensation. Method：Thirty stroke patients with foot drop were selected as the experimental group and 30 healthy subjects matched with sex and age were enrolled as the control group.Three -dimensional gait analysis system was used to collect and analyze the spatio-temporal parameters and the kinematic parameters of the pelvis and ankle joint in the swing phase of the experimental group and control group. The parameters of control group from the side with the matched hemiplegia side were taken into Group 1, and those from the side matched with non-paralyzed side were taken into group 2. Result：Compared with the non-hemiplegic side， the walking frequency and the percentage of support phase decreased， the maximum posterior inclination and pronation angle of the pelvis decreased， the maximum supination and upward inclination angle increased， range of motion （ROM）on sagittal plane，coronal plane and cross plane increased， the maximum ankle dorsiflexion decreased and the maximum ankle metatarsal flexion increased in paraplegia side. Compared with control group 1， the step length of hemiplegic side shortened， the step speed slowed， the step frequency decreased， the percentage of supporting phase prolonged， the maximum anteversion， supination， upward tilt angle，ROM of pelvis on sagittal plane and cross section increased， while the maximum pronation and downward inclination angle decreased， the maximum dorsiflexion angle and ROM of ankle joint decreased (all P<0.05) in paraplegia side. Compared with control group 2， the non-hemiplegic side showed shorter step length， slower walking speed， lower walking frequency， longer percentage of support period， increased maximum anteversion and posterior inclination of pelvis， decreased ROM on cross section and coronal plane， and decreased maximum metatarsal flexion angle and ROM of ankle joint (all P<0.05). In the hemiplegic side, there were a significant negative correlations between pelvic rotation and maximum ankle dorsiflexion and ankle metatarsal flexion (all P<0.05). A significant negative correlation between pelvic inclination and maximum ankle metatarsal flexion (all P<0.05). Conclusion： In stroke patients with foot drop， the characteristics of pelvic movement in swing phase are significant. There is a certain correlation between pelvis and ankle movement， and is affected by other joints.