摘要
目的:探求矫形器在康复工程上矫治作用,分析踝足矫形器对脑性瘫痪患儿康复治疗的可行性和有效性。方法:以2002-10/2004-06在福建省假肢中心治疗的下肢畸形的61例脑性瘫痪患儿为观察对象。所有患儿配戴矫形器治疗,应用了踝足矫形器95具,膝踝足矫形器8具、膝矫形器6具、足矫形器14具,除睡觉、洗澡外,要求全天候穿戴。患儿配戴矫形器后,每天参加康复训练和日常生活活动训练。治疗前和治疗18个月应用《使用矫形器前后Holden功能分类结果比较》(0级为无功能;Ⅰ级为需要大量持续性的帮助;Ⅱ级为小量帮助;Ⅲ级为需要监护或语言指导;Ⅳ级为平地独立行走;Ⅴ为完全独立行走)评估患儿步行功能,根据治疗前后级别变化分析踝足矫形器的矫治效果(改善1个级别为有效,改善2个级别以上为显效)。结果:61例患儿均进入结果分析。所有患儿治疗后达到控制下肢肌张力,控制膝反张、膝屈曲,纠正畸形步态,保持正确站立姿势及行走步态的效果,显效率为74%(45/61),总有效率为100%(61/61)。结论:矫形器在脑瘫矫治中能让患儿保持正确的肢位,维持或增大下肢各关节的活动范围,增强局部的稳定性,抑制肌张力、足原始反射、痉挛,预防肢体挛缩变形,同时提高步行质量和步行速度,使坐、立位的转换以及上下楼变得更为容易。矫形器治疗是综合康复治疗中一个有效的方法,一项重要的治疗手段。
AIM： To investigate the orthopaedic effects of orthosis in rehabilitation engineering by analyzing the reliability and validity of ankle-foot orthosis in the rehabilitation of children with cerebral palsy. METHODS： Sixty-one children with cerebral palsy who had deformed lower extremities wore orthoses in Fujian Provincial Center for Prosthetics from October 2002 to June 2004. In the used orthoses, 95 were ankle-foot orthosis（AFO）, 8 knee-ankle-foot orthosis（KAFO）, 6 knee orthosis and 14 foot orthosis （FO）. All the affected children were required to wear the orthoses at any time except sleep or bath, and they attended to rehabilitation exercise and activities of daily living every day after wearing the orthoses. Before treatment and at 18 months after treatment, the walking function was evaluated according to Comparison of Holden functional classification before and after application of orthoses（disability as grade 0, needing many and consecutive help as grade Ⅰ , needing a little help as grade Ⅱ, needing custody or oral instruction as grade Ⅲ, walking independently on the flat land as grade Ⅳ and walking independently and thoroughly as grade Ⅴ ）. The therapeutic and orthotic effects of AFO were analyzed according to the changes of grade before and after treatment （improvement by 1 grade was taken as effectiveness, and improvement by 2 or more grades as remarkable effectiveness）. RESULTS： All the 61 children were analyzed in the result. All the children had the sinew muscular tension of lower extremities, genu recurvatum and genu flexion controllable, made the deformed gait corrected, and kept correct standing stance and walking gait in the effective rate of 74%（45/61） and the total effective rate of 100%. CONCLUSION： Orthoses play an active role in the correction of cerebral palsy in terms of keeping correct position of extremities, maintaining or largening the range of motion of lower extremities, strengthening local stability, inhibiting muscular tension, foot initial reflex and spasm, prevent extremities from spasm or deformity, improving the quality of walking and walking speed, and making the position from sitting to standing and going upstairs or downstairs easier. So, orthosis therapy is one of the effect methods and one of the important tools in comprehensive rehabilitation.
出处
《中国临床康复》
CSCD
北大核心
2005年第27期176-177,共2页
Chinese Journal of Clinical Rehabilitation
