脑卒中偏瘫患者动态足底压力分析和步行功能评估研究

关键词：脑卒中  动态足底压力  步行功能  康复评定  可穿戴设备

Keywords:stroke  dynamic plantar pressure  walking function  wearable devices

摘要：

      摘要 目的：探究动态足底压力分析在脑卒中偏瘫患者步行功能评估中的作用。 方法：采用可穿戴足底压力分析系统，采集30例脑卒中患者及30例健康人6min步行过程中的动态足底压力数据，分析动态足底压力参数特征与步行能力的相关性；分析脑卒中偏瘫患者步行康复训练前后的动态足底压力变化，明确动态足底压力分析在脑卒中偏瘫患者步行功能评估中的作用。 结果：脑卒中患者在步行中患侧足跟后侧、前掌各区动态足底压力较健康人减小；患侧中足内侧动态足底压力较正常人增高。脑卒中患者的步行能力与足跟前侧、中足内侧、第1—5跖骨区及第1脚趾区、前掌区动态足底压力呈正相关关系。脑卒中患者康复训练后患侧足跟后侧、中足内侧、第4—5跖骨区和双侧第2—3跖骨区动态足底压力较训练前增加。 结论：动态足底压力分析系统能够敏感检测脑卒中偏瘫患者步行过程中的足底压力，并反映患者步行能力变化，有望应用于脑卒中偏瘫患者步行的长程监测。

Abstract:

      Abstract Objective： To explore the role of dynamic plantar pressure analysis in the assessment of walking function in stroke patients with hemiplegia. Method： A wearable plantar pressure analysis system was used to collect dynamic plantar pressure data during 6-minute walking in 30 stroke patients and 30 healthy people. The correlation between dynamic plantar pressure parameters and walking ability was analyzed. To analyze the dynamic plantar pressure changes in stroke patients with hemiplegia before and after walking rehabilitation training and clarify the role of dynamic plantar pressure analysis in the assessment of walking function in stroke patients with hemiplegia. Result： During 6-min walking， stroke patients exhibited lower peak pressure in the heel and forefoot regions on the affected side and higher peak pressure in the medial midfoot region on the affected side compared with healthy individuals. Walking ability was positively correlated with the dynamic plantar pressure in the anterior heel， medial midfoot， metatarsal regions 1—5， and the first toe. After rehabilitation training， the dynamic plantar pressure in the affected heel， medial midfoot， metatarsal regions 4—5， and bilaterally in metatarsal regions 2—3 increased significantly compared to pre-training levels (P<0.05). Conclusion： The dynamic plantar pressure analysis system sensitively detects the plantar pressure during walking and reflect the changes in walking ability of stroke patients with hemiplegia. It is expected to be used for long-term monitoring of walking in stroke patients with hemiplegia.