肘腕功能支具对脑卒中偏瘫患者足底压力和平衡功能的效果

doi:10.3969/j.issn.1006-9771.2026.01.004

《中国康复理论与实践》 ›› 2026, Vol. 32 ›› Issue (1): 30-39.doi: 10.3969/j.issn.1006-9771.2026.01.004

肘腕功能支具对脑卒中偏瘫患者足底压力和平衡功能的效果

吴澄¹^,², 章云枫², 王卫宁², 余克威², 张艳正³, 沈嘉蓉³, 吴毅²()

1.上海中医药大学，上海市 201203
2.复旦大学附属华山医院，上海市 200040
3.上海禾滨康复医院，上海市 201702

收稿日期:2025-07-08 修回日期:2025-09-19 出版日期:2026-01-25 发布日期:2026-01-28
通讯作者: 吴毅(1961-)，男，汉族，上海市人，博士，主任医师，教授，主要研究方向：中枢神经疾病后功能障碍的康复机制研究。E-mail： wuyi4000@163.com
作者简介:吴澄(1986-)，男，汉族，上海市人，硕士研究生，主管技师，主要研究方向：神经康复治疗。
基金资助:
1.上海市"科技创新行动计划"医学创新研究专项项目(22Y31900202);上海市"科技创新行动计划"医学创新研究专项项目(23Y11906300);2.上海市青浦区卫健委科研课题(QWJ2023-62)

Effect of elbow-wrist functional orthosis on plantar pressure and balance function in stroke patients with hemiplegia

WU Cheng¹^,², ZHANG Yunfeng², WANG Weining², YU Kewei², ZHANG Yanzheng³, SHEN Jiarong³, WU Yi²()

1. Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
2. Huashan Hospital Affiliated to Fudan University, Shanghai 200040, China
3. Shanghai Hebin Rehabilitation Hospital, Shanghai 201702, China

Received:2025-07-08 Revised:2025-09-19 Published:2026-01-25 Online:2026-01-28
Contact: WU Yi, E-mail: wuyi4000@163.com
Supported by:
Shanghai "Science and Technology Innovation Action Plan" Medical Innovation Research Special Project(22Y31900202);Shanghai "Science and Technology Innovation Action Plan" Medical Innovation Research Special Project(23Y11906300);Shanghai Qingpu District Health Commission Scientific Research Topic(QWJ2023-62)

摘要/Abstract

摘要：

目的探讨佩戴肘腕功能支具对脑卒中偏瘫患者足底压力和平衡功能的效果。

方法 2024年6月至2025年4月，复旦大学附属华山医院和上海禾滨康复医院收治的60例脑卒中偏瘫患者，随机分为对照组(n = 30)和观察组(n = 30)。对照组进行常规神经康复治疗，观察组增加偏瘫侧肘腕功能矫形器辅助训练，共8周。干预前后比较肘关节改良Ashworth量表(MAS)评级、足底压力对称性指数(SI)、足底压力面积和足底平均压强，并采用Berg平衡量表(BBS)、计时起立-行走测试(TUGT)和10米步行试验(10MWT)进行评定。

结果对照组脱落2例。干预后两组肘关节MAS分级、前足SI、患侧足底压力面积、BBS评分、TUGT和10MWT均明显改善(∣Z∣ > 3.969, ∣t∣ > 3.528, P < 0.01)，观察组后足SI和患足平均压强显著改善(∣t∣ > 4.264, P < 0.001)；除TUGT和10MWT外，观察组均优于对照组(∣Z∣ > 2.030, ∣t∣ > 2.096, P < 0.05)。

结论肘腕功能支具可通过降低上肢肌张力、调节重心分布和姿势控制，提高脑卒中偏瘫患者平衡功能。

关键词: 脑卒中, 偏瘫, 支具, 足底压力, 下肢运动功能

Abstract:

Objective To explore the effect of elbow-wrist functional orthosis on plantar pressure distribution and balance function in stroke patients with hemiplegia.

Methods From June, 2024 to April, 2025, 60 patients with post-stroke hemiplegia were recruited from Huashan Hospital, Fudan University, and Shanghai Hebin Rehabilitation Hospital. They were randomly divided into control group (n = 30) and intervention group (n = 30). The control group received routine neurological rehabilitation, while the intervention group received additional training with an elbow-wrist functional orthosis on the affected side, for eight weeks. Before and after intervention, the Modified Ashworth Scale (MAS) of the elbow joint, plantar pressure symmetry index (SI), plantar contact area and mean plantar pressure were recorded, and balance and mobility were assessed using the Berg Balance Scale (BBS), Timed Up & Go Test (TUGT) and 10-Meter Walk Test (10MWT).

Results Two cases dropped out in the control group. After treatment, MAS grades of the elbow joint, forefoot SI, affected side plantar pressure area, BBS scores, TUGT and 10MWT of both groups improved (|Z| > 3.969, |t| > 3.528, P < 0.01), while the hindfoot SI and average pressure of the affected foot improved in the intervention group (∣t∣ > 4.264, P < 0.001). Except for TUGT and 10MWT, the intervention group was superior to the control group (∣Z∣ > 2.030, ∣t∣ > 2.096, P < 0.05).

Conclusion The elbow-wrist functional orthosis can enhance balance function in stroke patients with hemiplegia by reducing upper-limb spasticity, optimizing center-of-gravity distribution, and improving postural control.

Key words: stroke, hemiplegia, orthosis, plantar pressure, lower limb motor function

中图分类号:

R743.3

吴澄, 章云枫, 王卫宁, 余克威, 张艳正, 沈嘉蓉, 吴毅. 肘腕功能支具对脑卒中偏瘫患者足底压力和平衡功能的效果[J]. 《中国康复理论与实践》, 2026, 32(1): 30-39.

WU Cheng, ZHANG Yunfeng, WANG Weining, YU Kewei, ZHANG Yanzheng, SHEN Jiarong, WU Yi. Effect of elbow-wrist functional orthosis on plantar pressure and balance function in stroke patients with hemiplegia[J]. Chinese Journal of Rehabilitation Theory and Practice, 2026, 32(1): 30-39.

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组别	n	性别(男/女)/n	年龄/岁	病程/周	卒中类型(梗死/出血)/n	偏瘫侧(左/右)/n
对照组	28	20/8	61.36±8.31	16.18±10.46	18/10	13/15
观察组	30	16/14	56.73±11.71	16.03±8.24	18/12	13/17
χ²/t值		2.014	-1.743	-0.059	0.113	0.056
P值		0.156	0.090	0.953	0.737	0.813

组别	n	测试	M(Q_L, Q_U)	Z值	P值
对照组	28	前测	3.0(3.0, 4.0)	-3.969	< 0.001
		后测	2.0(1.5, 3.0)
观察组	30	前测	3.0(3.0, 4.0)	-4.590	< 0.001
		后测	2.0(1.38, 2.0)
干预前均值差				-0.036	0.971
干预后均值差				-2.030	0.042

变量	组别	n	测试	$\stackrel{-}{x}\pm s$	t值	P值
双侧前足SI	对照组	28	前测	31.20±14.70	3.528	0.002
			后测	22.73±11.34
	观察组	30	前测	28.76±12.86	7.008	< 0.001
			后测	16.13±5.79
	干预前均值差			-2.44±3.62	-0.673	0.504
	干预后均值差			-6.61±2.39	-2.764	0.009
双侧后足SI	对照组	28	前测	23.21±15.58	0.282	0.780
			后测	22.43±11.58
	观察组	30	前测	25.72±15.81	5.365	< 0.001
			后测	16.35±7.54
	干预前均值差			2.51±4.13	0.609	0.545
	干预后均值差			-6.08±2.55	-2.387	0.020

变量	组别	n	测试	M(Q_L,Q_U)	Z值	P值
健足足底压力面积	对照组	28	前测	136.5(130.2, 140.0)	-0.606	0.544
			后测	134.0(128.5, 137.8)
	观察组	30	前测	132.5(128.0, 140.0)	-0.152	0.880
			后测	133.5(129.8, 138.0)
	干预前均值差				-0.577	0.564
	干预后均值差				-0.585	0.559
患足足底压力面积	对照组	28	前测	117.0(104.3, 126.8)	-4.013	< 0.001
			后测	127.5(121.5, 131.8)
	观察组	30	前测	109.5(97.8, 123.3)	-4.485	< 0.001
			后测	132.0(125.8, 137.5)
	干预前均值差				-0.973	0.330
	干预后均值差				-2.096	0.036

变量	组别	n	测试	$\stackrel{-}{x}\pm s$	t值	P值
健足平均压强	对照组	28	前测	40.00±4.52	2.014	0.054
			后测	39.20±4.25
	观察组	30	前测	39.53±4.43	3.163	0.004
			后测	37.03±3.07
	干预前均值差			-0.47±1.18	-0.398	0.692
	干预后均值差			-2.17±0.97	-2.243	0.029
患足平均压强	对照组	28	前测	26.30±4.24	-1.916	0.066
			后测	28.07±4.27
	观察组	30	前测	27.77±4.83	-4.264	< 0.001
			后测	31.28±3.00
	干预前均值差			1.47±1.20	1.227	0.225
	干预后均值差			3.22±0.96	3.337	0.002

肘腕功能支具对脑卒中偏瘫患者足底压力和平衡功能的效果

Effect of elbow-wrist functional orthosis on plantar pressure and balance function in stroke patients with hemiplegia

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变量	组别	n	测试	$\stackrel{-}{x}\pm s$	t值	P值
BBS	对照组	28	前测	16.25±7.11	-15.960	< 0.001
			后测	29.04±5.61
	观察组	30	前测	17.60±8.95	-17.877	< 0.001
			后测	36.87±6.64
	干预前均值差			1.35±2.13	0.633	0.529
	干预后均值差			7.83±1.62	4.834	< 0.001
TUGT/s	对照组	28	前测	24.75±4.46	9.623	< 0.001
			后测	18.38±3.43
	观察组	30	前测	23.89±4.45	12.754	< 0.001
			后测	17.17±3.06
	干预前均值差			-0.86±1.17	-0.734	0.466
	干预后均值差			-1.21±0.85	-1.417	0.162
10MWT/(cm·s^-1)	对照组	28	前测	36.21±6.84	-11.345	< 0.001
			后测	58.75±12.07
	观察组	30	前测	34.57±6.44	-16.226	< 0.001
			后测	64.57±11.22
	干预前均值差			-1.65±1.74	-0.945	0.349
	干预后均值差			5.82±3.06	1.903	0.062

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