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关节松动术和拉伸对脑卒中患者踝关节活动范围和时空步态变量的影响。

Effects of joint mobilization and stretching on the range of motion for ankle joint and spatiotemporal gait variables in stroke patients.

机构信息

Department of Physical Therapy, Graduate School, YongIn University, Republic of Korea.

Department of Physical Therapy, GangdDong University, 205ho, hongikgwan, 278, Daehak-gil, Gamgok-myeon, Eumseong-gun, Chungcheongbuk-do, Republic of Korea.

出版信息

J Stroke Cerebrovasc Dis. 2020 Aug;29(8):104933. doi: 10.1016/j.jstrokecerebrovasdis.2020.104933. Epub 2020 Jun 8.

Abstract

BACKGROUND AND PURPOSE

Stroke patients have limited ranges of motion and gait disturbances due to neurological deficits and connective tissue changes. We assessed the effects of joint mobilization and active stretching on ankle joint range of motion and gait in stroke patients.

METHODS

In total, 45 stroke patients were evenly divided into three groups: joint mobilization, active stretching, and combination (joint mobilization and active stretching) groups. Patients in each group received the corresponding interventions in a non-simultaneous manner for 6 weeks in total (3 days per week, 15 min per day). The range of motion of the ankle joint was measured using a goniometer, and spatiotemporal gait variables were measured using G-walk. All measurements were taken immediately before and after the 6-week intervention.

RESULTS

The joint mobilization group exhibited significantly increased range of motion for ankle joint after the intervention (p < 0.05), while the spatiotemporal gait variables were unchanged. In the active stretching group, both the range of motion of the ankle joint in the supine position and the spatiotemporal gait variables (cadence, speed, stride length) were significantly increased (p < 0.05). In the combination group, both the range of motion of the ankle joint and spatiotemporal gait variables (cadence, speed, stride length) were significantly increased (p < 0.05).

CONCLUSION

Combination therapy of joint mobilization and active stretching improves the range of motion of the ankle joint and spatiotemporal gait variables in stroke patients, suggesting that ankle rehabilitation of stroke patients should include limited joint structure and muscles shortness.

摘要

背景与目的

由于神经功能缺损和结缔组织变化,脑卒中患者的运动范围受限,步态紊乱。我们评估了关节松动术和主动拉伸对脑卒中患者踝关节活动范围和步态的影响。

方法

共 45 例脑卒中患者平均分为三组:关节松动组、主动拉伸组和联合组(关节松动和主动拉伸联合)。每组患者以非同步的方式接受相应的干预,总疗程为 6 周(每周 3 天,每天 15 分钟)。使用量角器测量踝关节活动范围,使用 G-walk 测量时空步态变量。所有测量均在 6 周干预前后立即进行。

结果

关节松动组干预后踝关节活动范围显著增加(p<0.05),而时空步态变量无变化。主动拉伸组仰卧位踝关节活动范围和时空步态变量(步频、速度、步长)均显著增加(p<0.05)。联合组踝关节活动范围和时空步态变量(步频、速度、步长)均显著增加(p<0.05)。

结论

关节松动术和主动拉伸的联合治疗可改善脑卒中患者踝关节活动范围和时空步态变量,提示脑卒中患者的踝关节康复应包括关节结构受限和肌肉短缩。

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