Nakipoğlu Yüzer Güldal F, Koyuncu Engin, Çam Pinar, Özgirgin Neşe
Department of Physical Medicine and Rehabilitation, Ankara Physical Medicine and Rehabilitation Training and Research Hospital, Ankara, Turkey.
Int J Rehabil Res. 2018 Sep;41(3):270-275. doi: 10.1097/MRR.0000000000000299.
This is a Retrospective descriptive study. Orthoses and walking aids are used frequently in stroke rehabilitation to facilitate ambulation. The aim was to describe the regularity of orthosis use and the reasons for disuse in stroke after discharge from inpatient rehabilitation. The study included 64 (43 men, 21 women) subacute stroke patients who had been discharged from our clinic in the last 6 months. Demographic and clinical findings, proposed orthoses and walking aids, frequency of usage for the proposed orthoses, reasons for disuse, and the ambulation levels were recorded. A total of 54 (84.4%) patients had an ankle-foot orthosis and 10 (15.6%) patients had a knee-ankle-foot orthosis. The orthosis frequency of use was every day in 38 (59.4%) patients and one to seven times a week in seven (10.9%) patients, whereas 19 (29.7%) did not use them. The reasons for orthosis disuse were finding them unnecessary in seven (27%) patients, usage difficulties in six (23%) patients, pressure sensation in five (19.2%) patients, the belief that they did not make life easier in five (19.2%) patients, lack of a suitable environment in one (3.8%) patient, orthosis wear in one (3.8%) patient, and systemic disease in one (3.8%) patient. Age, sex, residence, the disease duration, and recommended orthosis duration (how long the prescribed orthosis was used), recommended orthosis, range of motion limitation in the lower extremities, presence of spasticity, type of orthosis, and the ambulation level were not statistically significantly associated with the frequency of orthosis use (P>0.05). The only significant clinical factor for the frequency of orthosis use was the lower extremity Brunnstrom neurophysiological recovery stage (P<0.008). Orthosis use had been discontinued by 29% of the patients. The most common reasons reported for discontinuing orthosis use were that the patients found it unnecessary, usage difficulty, pressure sensation, not making life easier, lack of a suitable environment, and orthosis wear. The only significant clinical factor for the frequency of orthosis use was the lower extremity Brunnstrom neurophysiological recovery stage.
这是一项回顾性描述性研究。矫形器和助行器在中风康复中经常被用于促进步行。目的是描述中风患者出院后矫形器的使用规律及停用原因。该研究纳入了过去6个月内从我们诊所出院的64例（43例男性，21例女性）亚急性中风患者。记录了人口统计学和临床特征、建议使用的矫形器和助行器、建议使用的矫形器的使用频率、停用原因以及步行水平。共有54例（84.4%）患者使用了踝足矫形器，10例（15.6%）患者使用了膝踝足矫形器。矫形器的使用频率为：38例（59.4%）患者每天使用，7例（10.9%）患者每周使用1至7次，而19例（29.7%）患者未使用。停用矫形器的原因包括：7例（27%）患者认为不需要，6例（23%）患者使用困难，5例（19.2%）患者有压迫感，5例（19.2%）患者认为没有让生活更轻松，1例（3.8%）患者缺乏合适的环境，1例（3.8%）患者矫形器磨损，1例（3.8%）患者有全身性疾病。年龄、性别、居住地、病程、建议使用矫形器的时长（所开矫形器使用的时间）、建议使用的矫形器、下肢活动度受限、痉挛的存在、矫形器类型以及步行水平与矫形器使用频率在统计学上无显著相关性（P>0.05）。矫形器使用频率的唯一显著临床因素是下肢Brunnstrom神经生理恢复阶段（P<0.008）。29%的患者已停止使用矫形器。报告的停用矫形器最常见原因是患者认为不需要、使用困难、有压迫感、没有让生活更轻松、缺乏合适的环境以及矫形器磨损。矫形器使用频率的唯一显著临床因素是下肢Brunnstrom神经生理恢复阶段。
