中国正常成人步行时空参数研究及其临床应用
发布时间：2018-12-28 10:09
【摘要】：目的探讨中国正常成人的步行特征，为临床步态分析提供正常值参考。进一步通过比较偏瘫患者与正常人步行时空参数的差异，以及大腿截肢患者在安装假肢后不同时期步行时空参数变化，探讨步行时空参数分析在偏瘫和截肢康复中的临床应用价值。 方法365名正常受试者，按性别、年龄分为20-29岁组、30-39岁组、40-49岁组、50-59岁组、60-75岁组共10组。应用人体步态垫测量与分析系统，，测试受试者自由行走时的步行时空参数。同时收集26名偏瘫患者与21名大腿假肢佩戴者的步行时空参数，分别比较偏瘫患者与正常人、假肢佩戴者矫正过程中各时期步行时空参数的差异。 结果 1.年龄组内平均步速，除30-39岁组，60-75岁组外，男性均大于女性(P0.05)，50岁以后，男、女步速均减慢，与50岁以前相比具有显著性差异(P0.01)；各年龄组步长，男性均大于女性(P0.05)，女性步长在50岁以后减小，与50岁以前相比具有显著性差异(P0.01)，男性步长在60岁以后减小，明显小于60岁以前步长(P0.01)。 2.偏瘫患者双侧步速、步长、支撑时间及支撑时间百分比与正常对照组相比均具有显著性差异(P0.01)。偏瘫患者步速、步长明显低于对照组，两者之间具有显著性差异(P0.01)；而支撑时间及支撑时间百分比明显高于对照组，差异亦具有显著性(P0.01)。 3.穿戴假肢1月后与1周后、3月后与1月后相比，假肢使用者步速、步长均显著增加(P0.01)，而单足支撑时间显著减小(P0.01)。穿戴假肢3月后，假肢使用者步速、步长与正常对照组相比稍减小(P0.05)；单足支撑时间与正常对照组相比无明显差异(P0.05)。同时，假肢使用者健、患两侧步态对称性(健/患)在假肢矫正过程中也逐渐趋近于1。 结论 1.应用人体步态垫测量与分析系统，首次建立中国正常成人步行时空参数参考值范围，初步揭示中国正常成人的步行时空特征； 2.偏瘫患者与正常成人步行时空参数的差异，可为临床制订偏瘫康复治疗方案、评定康复疗效提供简单、量化的依据； 3.步行时空参数分析在截肢康复中用于假肢定型、矫正及假肢使用者步行功能评定，是一种简便、定量、敏感的步态评定方法，具有重要的临床应用价值。
[Abstract]:Objective to study the walking characteristics of Chinese normal adults and to provide reference for clinical gait analysis. By comparing the difference of walking time and space parameters between hemiplegic patients and normal subjects, and the changes of walking time and space parameters of patients with thigh amputation at different time after prosthesis installation, To explore the clinical application value of walking time-space parameter analysis in hemiplegia and amputation rehabilitation. Methods 365 normal subjects were divided into 10 groups according to their sex: 20-29 years old, 30-39 years old, 40-49 years old, 50-59 years old, 60-75 years old group. The measurement and analysis system of human gait pad was used to measure the parameters of walking time and space when the subjects were walking freely. At the same time, the walking time and space parameters of 26 patients with hemiplegia and 21 patients with thigh prosthesis wearer were collected to compare the time and space parameters of walking between the patients with hemiplegia and the normal persons and the prosthetic wearers. Result 1. The average walking speed in the age group was higher than that in the female except the 30-39 years old group and 60-75 years old group (P0.05). After 50 years old, the walking speed of the male and female slowed down, and there was significant difference between the male and the female before 50 years old (P0.01). The step length of each age group was larger than that of female (P0.05). The step length of female decreased after 50 years old (P0.01) compared with that before 50 years old (P0.01), and the step length of male decreased after 60 years old. The stride was obviously less than 60 years old (P0.01). 2. The bilateral step speed, step length, support time and the percentage of support time in hemiplegic patients were significantly different from those in the normal control group (P0.01). The walking speed and step length of hemiplegic patients were significantly lower than that of the control group (P0.01), while the percentage of supporting time and supporting time were significantly higher than that of the control group (P0.01). 3. After one month and one week, three months later and one month later, the walking speed and step length of the prosthesis users increased significantly (P0.01), while the support time of one foot decreased significantly (P0.01). Three months after wearing prosthetic limb, the walking speed and step length of the prosthetic user decreased slightly compared with the normal control group (P0.05); the time of single foot support was not significantly different from that of the normal control group (P0.05). At the same time, the prosthetic user's health and bilateral gait symmetry (health / disease) also gradually approach to 1. 1 in the process of prosthesis correction. Conclusion 1. By using the human gait pad measurement and analysis system, the reference range of spacetime parameters of walking for Chinese normal adults is established for the first time to reveal the space-time characteristics of walking of Chinese normal adults. 2. The difference of walking time and space parameters between patients with hemiplegia and normal adults can provide a simple and quantitative basis for clinical treatment of hemiplegia and evaluation of rehabilitation effect. 3. The analysis of time and space parameters of walking is a simple, quantitative and sensitive method to assess the gait function of amputation and rehabilitation. It has important clinical application value.
【学位授予单位】：第三军医大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R339.4
本文编号：2393819
[Abstract]:Objective to study the walking characteristics of Chinese normal adults and to provide reference for clinical gait analysis. By comparing the difference of walking time and space parameters between hemiplegic patients and normal subjects, and the changes of walking time and space parameters of patients with thigh amputation at different time after prosthesis installation, To explore the clinical application value of walking time-space parameter analysis in hemiplegia and amputation rehabilitation. Methods 365 normal subjects were divided into 10 groups according to their sex: 20-29 years old, 30-39 years old, 40-49 years old, 50-59 years old, 60-75 years old group. The measurement and analysis system of human gait pad was used to measure the parameters of walking time and space when the subjects were walking freely. At the same time, the walking time and space parameters of 26 patients with hemiplegia and 21 patients with thigh prosthesis wearer were collected to compare the time and space parameters of walking between the patients with hemiplegia and the normal persons and the prosthetic wearers. Result 1. The average walking speed in the age group was higher than that in the female except the 30-39 years old group and 60-75 years old group (P0.05). After 50 years old, the walking speed of the male and female slowed down, and there was significant difference between the male and the female before 50 years old (P0.01). The step length of each age group was larger than that of female (P0.05). The step length of female decreased after 50 years old (P0.01) compared with that before 50 years old (P0.01), and the step length of male decreased after 60 years old. The stride was obviously less than 60 years old (P0.01). 2. The bilateral step speed, step length, support time and the percentage of support time in hemiplegic patients were significantly different from those in the normal control group (P0.01). The walking speed and step length of hemiplegic patients were significantly lower than that of the control group (P0.01), while the percentage of supporting time and supporting time were significantly higher than that of the control group (P0.01). 3. After one month and one week, three months later and one month later, the walking speed and step length of the prosthesis users increased significantly (P0.01), while the support time of one foot decreased significantly (P0.01). Three months after wearing prosthetic limb, the walking speed and step length of the prosthetic user decreased slightly compared with the normal control group (P0.05); the time of single foot support was not significantly different from that of the normal control group (P0.05). At the same time, the prosthetic user's health and bilateral gait symmetry (health / disease) also gradually approach to 1. 1 in the process of prosthesis correction. Conclusion 1. By using the human gait pad measurement and analysis system, the reference range of spacetime parameters of walking for Chinese normal adults is established for the first time to reveal the space-time characteristics of walking of Chinese normal adults. 2. The difference of walking time and space parameters between patients with hemiplegia and normal adults can provide a simple and quantitative basis for clinical treatment of hemiplegia and evaluation of rehabilitation effect. 3. The analysis of time and space parameters of walking is a simple, quantitative and sensitive method to assess the gait function of amputation and rehabilitation. It has important clinical application value.
【学位授予单位】：第三军医大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R339.4
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