3D本体感受鞋垫对老年脑卒中后足下垂内翻患者平衡和足底压力的影响

Effects of 3D proprioceptive insole on balance and plantar pressure in elderly patients with foot drop and varus after stroke

中文关键词: 老年  脑卒中  鞋垫  康复  3D打印

英文关键词: elderly  stroke  insole  rehabilitation  3D printing

中文摘要:

      目的 观察3D本体感受鞋垫对老年脑卒中后足下垂内翻患者平衡和足底压力的影响.方法 选取2021年6月—2023年10月在上海市第四康复医院神经康复科住院及门诊病情平稳的老年脑卒中后足下垂内翻患者60例,采用电脑随机法分成3D本体感受鞋垫组(鞋垫组)和足踝矫形器组(AFO组),每组30例.鞋垫组在常规康复治疗基础上给予3D本体感受鞋垫治疗,AFO组在常规康复治疗基础上给予AFO治疗,2组连续治疗6周.对2组患者选用BBS、FMA、步态分析及Footscan足底压力系统进行评估,比较2组患者治疗前和治疗6周后的评估值差异.结果 治疗前,2组患者步长、步速、步频、BBS和FMA评分差异均无统计学意义(P＞0.05).治疗6周后,2组患者步长、步频均长/大于同组治疗前(P＜0.05),而2组间差异均无统计学意义(P＞0.05);2组患者步速、BBS和FMA评分均快/高于同组治疗前(P＜0.05),鞋垫组步速、BBS和FMA评分均快/高于AFO组(P＜0.05).治疗前,2组患侧足底内外侧压力、足底内外侧接触面积组间差异无统计学意义(P＞0.05).治疗6周后,2组患侧足底外侧压力、外侧接触面积均较同组治疗前减少(P＜0.05),但2组间差异无统计学意义(P＞0.05);2组患侧足底内侧压力、足底内侧接触面积较同组治疗前增加(P＜0.05),鞋垫组患侧足底内侧压力、足底内侧接触面积均大于AFO组(P＜0.05).结论 与AFO比较,3D本体感受鞋垫能更有效提高老年脑卒中后足下垂内翻患者平衡功能和足底压力.

英文摘要:

      Objective To observe the effects of 3D proprioceptive insole on balance and plantar pressure in elderly pa-tients with foot drop and varus after stroke.Methods A total of 60 elderly patients with stable condition of foot drop and varus after stroke treated in Department of Neurological Rehabilitation,Fourth Rehabilitation Hospital of Shanghai City from June 2021 to October 2023 were selected.They were randomly divided into 3D proprioceptive insole group(insole group)and ankle orthosis group(AFO group)by computer randomization method,with 30 cases in each group.On the basis of conven-tional rehabilitation treatment,the insole group received 3D proprioceptive insole treatment and the AFO group received AFO treatment.Both groups were treated continuously for 6 weeks.Berg Balance Scale(BBS),Fugl-Meyer Assessment(FMA),Gait Analysis and Footscan Plantar Pressure System were used to evaluate the two groups of patients.The differences in the evaluation values of the two groups before treatment and after 6 weeks of treatment were compared.Results Before treatment,there was no significant difference in step length,step speed,step frequency,BBS score and FMA score between the two groups(P＞0.05).After 6 weeks of treatment,the step length and step frequency of the two groups were longer/higher than those of the same group before treatment(P＜0.05),but there was no significant difference between the two groups(P＞0.05);the step speed,BBS score and FMA score of the two groups were faster/higher than those of the same group before treatment(P＜0.05),and the insole group were faster/higher than the AFO group(P＜0.05).Before treatment,there was no significant difference in the medial and lateral plantar pressure of the affected foot and the medial and lateral plantar contact area between the two groups(P＞0.05).After 6 weeks of treatment,the lateral plantar pressure and lateral contact area of the affected side in both groups decreased compared to before treatment in the same group(P＜0.05),but there was no statistical-ly significant difference between the two groups(P＞0.05);the medial plantar pressure and medial plantar contact area of the affected side in both groups increased compared to before treatment in the same group(P＜0.05),and the insole group were higher than the AFO group(P＜0.05).Conclusion Compared with AFO,3D proprioceptive insoles can improve balance function and plantar pressure more effectively in elderly patients with foot drop and varus after stroke.