不完全性脊髓损伤患者运动功能对称性与步态对称性的关系

doi:10.3969/j.issn.1006-9771.2023.06.003

《中国康复理论与实践》 ›› 2023, Vol. 29 ›› Issue (6): 639-645.doi: 10.3969/j.issn.1006-9771.2023.06.003

• 专题运动功能与身体活动评定 • 上一篇下一篇

不完全性脊髓损伤患者运动功能对称性与步态对称性的关系

王一吉¹^,²^,³, 周红俊¹^,²(), 何泽佳¹^,², 刘根林¹^,², 郑樱¹^,², 郝春霞¹^,², 卫波¹^,², 康海琼¹^,², 张缨¹^,², 逯晓蕾¹^,², 袁媛¹^,², 蒙倩茹¹^,²

1.中国康复研究中心北京博爱医院，北京市 100068
2.首都医科大学康复医学院，北京市100068
3.日本藤田医科大学，日本名古屋 4701192

收稿日期:2022-10-10 修回日期:2023-03-22 出版日期:2023-06-25 发布日期:2023-07-14
通讯作者: 周红俊，E-mail： zh87569303@qq.com
作者简介:王一吉(1982-)，男，汉族，湖南衡阳市人，医学博士，副主任医师，主要研究方向：脊髓损伤康复。
基金资助:
1.中国康复研究中心科研基金项目(2020-Q8);2.国家重点研发计划项目(2020YFC2007505)

Relationship between symmetry of lower limb function and gait symmetry in patients with incomplete spinal cord injury

WANG Yiji¹^,²^,³, ZHOU Hongjun¹^,²(), HE Zejia¹^,², LIU Genlin¹^,², ZHENG Ying¹^,², HAO Chunxia¹^,², WEI Bo¹^,², KANG Haiqiong¹^,², ZHANG Ying¹^,², LU Xiaolei¹^,², YUAN Yuan¹^,², MENG Qianru¹^,²

1. Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing 100068, China
2. Capital Medical University School of Rehabilitation Medicine, Beijing 100068, China
3. Fujita Healthy University, Nagoya 4701192, Japan

Received:2022-10-10 Revised:2023-03-22 Published:2023-06-25 Online:2023-07-14
Contact: ZHOU Hongjun, E-mail: zh87569303@qq.com
Supported by:
China Rehabilitation Research Center Fund for Research(2020-Q8);China National Key R & D Program(2020YFC2007505)

摘要/Abstract

摘要：

目的观察不完全性脊髓损伤患者步态对称性特点及影响因素。
方法 2018年5月至2021年11月，北京博爱医院不完全性脊髓损伤患者34例，根据左右下肢运动评分的差异分为下肢对称损伤组(对称组，n = 15)和下肢非对称损伤组(非对称组，n = 19)。采用三维运动采集系统和足底压力采集系统进行步态测试。计算步长以及站立相和迈步相对称值。
结果对称组的步长对称值、站立相对称值和迈步相对称值均明显低于非对称组(|t| > 2.619, P < 0.01)。非对称组站立相对称值和迈步相对称值与双侧下肢肌力差值呈正相关(r > 0.468, P < 0.01)。判别分析显示，下肢损伤不同对称性患者的步态参数方程不同。
结论下肢运动功能对称性影响脊髓损伤患者步态对称性，左右下肢运动总分的差值是重要的影响因素。步态参数可用于判定脊髓损伤患者的下肢损伤对称性。

关键词: 脊髓损伤, 步态, 运动功能, 下肢, 对称性

Abstract:

Objective To observe the characteristics of gait symmetry and its influencing factors in patients with incomplete spinal cord injury (ISCI).
Methods From May, 2018 to November, 2021, 34 patients with ISCI in Beijing Bo'ai Hospital were divided into symmetrical injury of lower limb (SI) group and asymmetrical injury of lower limb (ASI) group according to the lower extremities motor score (LEMS). Three dimensional motion acquisition system and plantar pressure acquisition system were used for gait test. The symmetry indexes of step length, stance time and swing time were caculated.
Results The symmetry indexes of step length, stance time and swing time were significant lower in SI group than in ASI group (|t| > 2.619, P < 0.01). Stance time and swing time significantly correlated to the difference of bilateral LEMS in ASI group (r > 0.468, P < 0.01). Discriminant analysis showed that gait parameter equations were different for patients with different symmetry of lower limb injuries.
Conclusion The symmetry of lower limb motor function impacts gait symmetry for patients with ISCI, especially the difference value of bilateral total LEMS. Gait parameters can be used to determine the symmetry of lower limb injury in patients with ISCI.

Key words: spinal cord injury, gait, motor function, lower limb, symmetry

中图分类号:

R651.2

王一吉, 周红俊, 何泽佳, 刘根林, 郑樱, 郝春霞, 卫波, 康海琼, 张缨, 逯晓蕾, 袁媛, 蒙倩茹. 不完全性脊髓损伤患者运动功能对称性与步态对称性的关系[J]. 《中国康复理论与实践》, 2023, 29(6): 639-645.

WANG Yiji, ZHOU Hongjun, HE Zejia, LIU Genlin, ZHENG Ying, HAO Chunxia, WEI Bo, KANG Haiqiong, ZHANG Ying, LU Xiaolei, YUAN Yuan, MENG Qianru. Relationship between symmetry of lower limb function and gait symmetry in patients with incomplete spinal cord injury[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(6): 639-645.

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组别	n	性别 (男/女)/n	年龄/岁	身高/cm	体质量/kg	双下肢运动总分	肌张力	步速/(m·s^-1)	损伤平面/n		AIS分级/n		人辅助/n		辅助器/n
组别	n	性别 (男/女)/n	年龄/岁	身高/cm	体质量/kg	双下肢运动总分	肌张力	步速/(m·s^-1)	颈段	胸腰段	C	D	是	否	是	否
对称组	15	13/2	38±15	172.4±4.8	69.8±10.8	36.9±3.8	0±1	0.2±0.1	6	9	1	14	6	9	1	14
非对称组	19	11/8	44±17	169.1±8.9	67.5±11.8	33.8±5.8	0±1	0.2±0.1	9	10	1	18	10	9	0	19
χ²/t/Z值		3.342	1.073	-1.315	-0.579	-1.802	-0.400	-0.542	0.185		0.030		0.537		1.305
P值		0.128	0.291	0.198	0.566	0.081	0.689	0.592	0.738		1.000		0.510		0.441

组别	n	步长对称值	站立相对称值	迈步相对称值
对称组	15	0.147±0.096	0.004±0.023	0.205±0.156
非对称组	19	0.364±0.275	0.112±0.082	0.508±0.329
t值		-2.619	3.390	3.281
P值		0.009	0.002	0.003

变量	步长对称值	站立相对称值	迈步相对称值
步速	-0.393	0.557^b	-0.189
跨步长	-0.582^a	0.150	-0.254
左侧下肢运动总分	-0.321	0.319	-0.091
右侧下肢运动总分	-0.321	0.319	-0.091

变量	步长对称值	站立相对称值	迈步相对称值
步速	-0.179	0.237	-0.254
跨步长	-0.533^a	0.312	-0.246
瘫痪重侧下肢运动总分	-0.051	-0.198	-0.290
瘫痪轻侧下肢运动总分	-0.372	0.442	0.586^c
双侧肌力差值	0.251	0.468^b	0.625^d

不完全性脊髓损伤患者运动功能对称性与步态对称性的关系

Relationship between symmetry of lower limb function and gait symmetry in patients with incomplete spinal cord injury

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