Ofluoglu Demet, Esquenazi Alberto, Hirai Barbara
Department of Physical Medicine and Rehabilitation, Marmara University School of Medicine, Istanbul, Turkey.
Am J Phys Med Rehabil. 2003 Nov;82(11):832-6. doi: 10.1097/01.PHM.0000091986.32078.CD.
The management of spasticity should be implemented with the most appropriate pharmacologic agents. Ideally, these agents should provide functional improvement with minimal adverse effects. The aim of this study was to evaluate the width of the base of support and the velocity of gait before and after obturator nerve block. Blocks were performed with aqueous phenol solution in patients with unilateral hip adductor muscle overactivity that resulted in scissoring gait. The goal was to analyze functional improvement and quantify outcomes and to attempt to document adverse effects.
This retrospective study analyzed data from 24 patients' files. Inclusion criteria included subjects whose main functional complaint was an adducted gait pattern. All subjects were able to consent for and to undergo unilateral obturator neurolysis with 7% phenol solution. Temporospatial parameters of gait were obtained using the Gait Mat II before and after obturator nerve injection.
The analysis showed no statistical change in the walking velocity or step length. However, the width of the base of support was significantly increased after injection. No postblock complications were reported.
Obturator neurolysis with 7% phenol solutions is an effective procedure to decrease hip adductor muscle overactivity without reported complications. In the studied population, improvement was found in the width of the base of support without immediate change in walking velocity or step length.
痉挛的管理应采用最合适的药物进行。理想情况下，这些药物应在产生最小副作用的同时改善功能。本研究的目的是评估闭孔神经阻滞前后的支撑基底宽度和步态速度。对单侧髋内收肌活动过度导致剪刀步态的患者，采用苯酚水溶液进行阻滞。目的是分析功能改善情况、量化结果并尝试记录不良反应。
这项回顾性研究分析了24例患者档案中的数据。纳入标准包括主要功能主诉为内收步态模式的受试者。所有受试者均能够同意并接受用7%苯酚溶液进行单侧闭孔神经松解术。在闭孔神经注射前后，使用步态垫II获取步态的时空参数。
分析显示步行速度或步长无统计学变化。然而，注射后支撑基底宽度显著增加。未报告阻滞术后并发症。
用7%苯酚溶液进行闭孔神经松解术是一种有效的减少髋内收肌活动过度的方法，且未报告并发症。在研究人群中，支撑基底宽度有所改善，而步行速度或步长没有立即改变。
