便携式步态分析仪在脊髓型颈椎病中的应用

发布时间：2018-03-06 11:27

  本文选题：脊髓型颈椎病　切入点：步态分析　出处：《大连医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：背景.·在提倡精准医学的今天,脊髓型颈椎病的评价系统仍显得不够客观。有研究证实步态分析有助于脊髓型颈椎病的早期诊断,并可对其严重程度、治疗效果等做出客观、量化的评估。较传统的三维步态实验室分析系统而言,便携式步态分析系统具有操作简单、携带方便等优点,其更易于应用于临床,未来在脊髓型颈椎病中应用前景广阔。目前,便携式步态分析仪应用于脊髓型颈椎病的相关研究较少。目的:探讨便携式步态分析仪临床应用于脊髓型颈椎病的可行性,同时了解该病患者的步态特点,明确步态参数变化可否作为反映病情的客观、量化评价指标,为同类研究作出参考。方法:在严格遵循纳入标准的前提下,选择大连医科大学附属第一医院脊柱外科2016年9月至11月期间脊髓型颈椎病住院患者15例,健康受试者15例。采用大连理工大学设计的便携式步态分析仪在大连医科大学附属第一医院脊柱外科病房内进行步态数据检测及收集。采用spss18.0软件包对收集数据进行统计分析,应用t检验比较脊髓型颈椎病患者和健康受试者的步态参数差异。采用spearman相关分析对脊髓型颈椎病患者步态参数与改良日本骨科学会评分之间的相关性进行统计学分析,全部检验均行双侧检验,结果以P0.05为差异有统计学意义。结果:本次实验中,患者组与对照组受试者在性别比例、年龄、身高、体质量、体质量指数差异方面均无统计学意义。患者组的步速、步长、跨步长、廓清、足跖屈角、足背屈角、足支撑相百分比和足摆动相百分比与对照组差异存在显著性(P0.05)。患者组足支撑相百分比较对照组明显增加,而步速、步长、跨步长、足廓清、足跖屈角、足背屈角和足摆动相百分比明显减少。患者组的改良日本骨科学会评分与足跖屈角度、支撑相百分比、摆动相百分比呈极强相关,与步速、足支撑相、跨步长、足廓清、步宽强相关。患者组的改良日本骨科学会下肢功能评分与步速呈极强相关、与足支撑相、步态周期、步长、跨步长、步宽、足廓清、足支撑相百分比、足摆动相百分比强相关。结论:(1)与健康人相比脊髓型颈椎病患者等距离下步速明显降低,步长、跨步长明显缩短,最大足廓清明显降低。足跖屈角度、足背屈角度明显减小。足支撑相百分比明显增加而摆动相百分比明显缩短。(2)脊髓型颈椎病患者随着改良日本骨科学会评分降低其步速、跨步长、廓清下降,足摆动相百分比和跖屈角度减小,支撑相时间及百分比增加。当改良日本骨科学会下肢功能评分降低时,其步速、步长、跨步长、足摆动相时间百分比和廓清随之下降,而步态周期、支撑相时间、支撑相时间百分比随之增长。(3)便携式步态分析仪可以对脊髓型颈椎病的严重程度作出客观、量化评估。同时,由于具有体积小、重量轻、便于穿戴的优点,未来应用前景广阔。
[Abstract]:Background... Today, the evaluation system of cervical Spondylotic myelopathy is still not objective. Some studies have proved that gait analysis is helpful to the early diagnosis of cervical Spondylotic myelopathy, and can make an objective view of the severity and therapeutic effect of cervical Spondylotic Spondylotic Spondylotic Myelopathy. Quantitative evaluation. Compared with the traditional three-dimensional gait laboratory analysis system, the portable gait analysis system has the advantages of simple operation and easy to carry. The application of portable gait analyzer in cervical Spondylotic myelopathy has a broad prospect in the future. At present, there are few related studies on the application of portable gait analyzer in cervical Spondylotic myelopathy. Objective: to explore the feasibility of clinical application of portable gait analyzer in cervical Spondylotic myelopathy. At the same time, we know the gait characteristics of the patients, determine whether the gait parameter change can be used as the objective and quantitative evaluation index to reflect the condition of the disease, and make reference for the similar research. Methods: under the premise of strictly following the inclusion criteria, Fifteen patients with cervical Spondylotic myelopathy from September 2016 to November in the first affiliated Hospital of Dalian Medical University were selected. A portable gait analyzer designed by Dalian University of Technology was used to detect and collect gait data in the spinal surgery ward of the first affiliated Hospital of Dalian Medical University. The collected data were statistically analyzed by spss18.0 software package. T test was used to compare the gait parameters between patients with cervical Spondylotic myelopathy and healthy subjects. The correlation between gait parameters and the score of the modified Japanese Orthopaedic Association was analyzed statistically by spearman correlation analysis in patients with cervical Spondylotic myelopathy. Results: in this experiment, the sex ratio, age, height, body weight, sex ratio, age, height, body weight of the patients and the control group were significantly higher than that of the control group. There was no significant difference in body mass index. The step speed, step length, stride length, clearance, plantar flexion angle, dorsal flexion angle of foot, The percentage of foot support phase and the percentage of foot swing phase were significantly different from those of the control group (P 0.05). The percentage of foot support phase in the patient group was significantly higher than that in the control group, while the step speed, step length, stride length, foot clearance and plantar flexion angle were significantly increased in the patient group. The score of the modified Japanese Orthopedic Society in the patient group was significantly correlated with the angle of plantar flexion, the percentage of the supporting phase, the percentage of the swing phase, and the step speed, the foot support phase, the stride length, and the foot clearance. The score of lower limb function of the modified Japanese Orthopedic Society in the patient group was strongly correlated with the walking speed, and was associated with the foot support phase, gait cycle, gait length, stride length, step width, foot clearance, and percentage of foot support phase. Conclusion compared with the healthy people, the walking speed, step length and stride length of the patients with cervical Spondylotic myelopathy at the same distance were significantly decreased, the maximal clearance of the foot was obviously decreased, and the angle of plantar flexion of the foot was obviously decreased. The percentage of foot support phase and swing phase were significantly increased and the percentage of cervical Spondylotic myelopathy decreased with the improved Japanese Orthopedic Association score. The percentage of swing phase and the angle of metatarsal flexion decreased, the time and percentage of supporting phase increased. When the score of lower limb function of the modified Japanese orthopedic society decreased, the step speed, step length, stride length, percentage of time and clearance of foot swing phase decreased. And the gait period, the support phase time, and the percentage of the support phase time increase with it.) the portable gait analyzer can make an objective and quantitative evaluation of the severity of cervical Spondylotic myelopathy. At the same time, because of its small size and light weight, Easy to wear the advantages of the future application prospects.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R681.55
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本文编号：1574644