Maeshima Shinichiro, Okazaki Hideto, Okamoto Sayaka, Mizuno Shiho, Asano Naoki, Maeda Hirofumi, Masaki Mitsuko, Matsuo Hiroshi, Tsunoda Tetsuya, Sonoda Shigeru
Department of Rehabilitation Medicine II, School of Medicine, Fujita Health University, Tsu, Japan.
Department of Rehabilitation Medicine II, School of Medicine, Fujita Health University, Tsu, Japan.
J Stroke Cerebrovasc Dis. 2015 Jun;24(6):1312-6. doi: 10.1016/j.jstrokecerebrovasdis.2015.02.003. Epub 2015 Apr 16.
We investigated differences in factors affecting judgments regarding the creation of new adjustable posterior strut knee-ankle-foot orthoses (APS-KAFO) and knee-ankle-foot orthoses with metal struts (traditional KAFO) for hemiplegic stroke patients for whom KAFO were created in rehabilitation wards.
Subjects were 50 patients with hemiplegia due to new-onset stroke (cerebral infarction: n = 25, cerebral hemorrhage: n = 25) who were prescribed KAFO. Patient ages ranged from 36 to 90 years, and the mean duration from stroke onset to hospitalization was 28.8 ± 13.8 days. Neurologic symptoms, cognitive function, activities of daily living, duration from hospitalization to orthosis creation, hospitalization duration, walking ability at discharge, outcome after discharge, and so forth were compared.
Fourteen patients were prescribed APS-KAFO, and 36 were prescribed traditional KAFO. Those prescribed APS-KAFO had somewhat milder neurologic symptoms and cognitive dysfunction and a shorter hospitalization duration than those prescribed traditional KAFO. Patients prescribed APS-KAFO also had a higher score and efficiency on functional independence measure at admission and discharge. Walking independence at discharge was seen in 8 of the 14 patients for whom APS-KAFO were created and 8 of the 36 patients for whom traditional KAFO were created.
APS-KAFO was chosen for patients with a high level of activity in the ward and with a higher likelihood of acquiring walking ability using APS-AFO at discharge, whereas traditional KAFO tended to be chosen for patients with relatively severe symptoms who were not expected to acquire practical walking ability.
我们调查了影响为在康复病房制作膝踝足矫形器（KAFO）的偏瘫中风患者创建新型可调式后支柱膝踝足矫形器（APS-KAFO）和金属支柱膝踝足矫形器（传统KAFO）的判断因素的差异。
研究对象为50例因新发中风（脑梗死：n = 25，脑出血：n = 25）而开具KAFO处方的偏瘫患者。患者年龄在36至90岁之间，中风发作至住院的平均时长为28.8±13.8天。比较了神经症状、认知功能、日常生活活动能力、从住院到制作矫形器的时长、住院时长、出院时的步行能力、出院后的结局等。
14例患者开具了APS-KAFO处方，36例开具了传统KAFO处方。开具APS-KAFO的患者神经症状和认知功能障碍稍轻，住院时长比开具传统KAFO的患者短。开具APS-KAFO的患者在入院和出院时的功能独立性测量得分及效率也更高。在制作了APS-KAFO的14例患者中有8例在出院时实现了步行独立，在制作了传统KAFO的36例患者中有8例实现了步行独立。
对于在病房活动水平较高且出院时使用APS-AFO获得步行能力可能性较大的患者，选择了APS-KAFO，而对于预计无法获得实际步行能力的症状相对较重的患者，则倾向于选择传统KAFO。
