【摘要】 背景:既往踝足矫形器中主要侧重于保护、矫治、稳定、代偿等功能,因此探讨踝关节功能障碍康复治疗的新方法具有重要意义。目的:观察深圳市龙岗中心医院康复科自主研发的计算机辅助下可动式踝足关节计量矫形器对踝关节骨折修复术后功能障碍的疗效。方法:选择踝部骨折内固定修复术后3周的患者52例,按照随机数字表法分为2组,每组26例,2组均予以常规口服药物及常规康复疗法,对照组在此基础上辅以关节松动术治疗,试验组在此基础上辅以计算机辅助下可动式踝足关节计量矫形治疗,每组采取不同的训练方法,20 min/d,6 d/周,共训练4周。采取计算机评定的肌力水平、主动关节活动度、Kofoed踝关节评分及目测类比评分进行疗效评价,观察训练前、开始训练后第7,14,28天的治疗效果。结果与结论:(1)2组入组时的一般资料及踝关节功能评分比较差异无显著性意义(P>0.05),具有可比性;在训练4周后两组上述指标均有改善(P<0.05);(2)试验组开始训练后第7,14,28天的计算机评定的肌力水平、Kofoed踝关节评分、目测类比评分均较对照组相应时间点改善,差异有显著性意义(P<0.05);(3)试验组训练后第28天的跖屈主动关节活动度大于对照组,差异有显著性意义(P<0.05);试验组训练后第7,14天背伸和跖屈主动关节活动度、第28天背伸主动关节活动度与对照组相比,差异无显著性意义(P>0.05);(4)结果表明,计算机辅助下可动式踝足关节计量矫形器以其不同于传统踝足矫形器的功能和特点,可以减轻踝关节骨折术后的疼痛,增强踝部肌力,改善踝关节活动度。更多还原

【Abstract】 BACKGROUND: The traditional ankle-foot orthosis focuses on the protection, correction, stability, and compensation; therefore, it is important to explore a new rehabilitation method for ankle joint dysfunction. OBJECTIVE: To explore the effect of computer-aided movable and measurable ankle-foot orthosis that designed by the Department of Rehabilitation in Longgang Central Hospital of Shenzhen on postoperative dysfunction after ankle fracture. METHODS: Fifty-two patients with ankle fractures at 3 weeks after internal fixation were selected and equivalently randomized into two groups. Both groups received conventional oral medication and rehabilitation therapy. In addition, the patients in control group were given joint mobilization treatment, while those in experimental group were given computer-aided movable and measurable of ankle-foot orthosis, 20 minutes daily, 6 days weekly for consecutive 4 weeks. The efficacy was evaluated by muscle strength, active range of motion, Kofoed ankle score and visual analogue scale on computer at baseline, 7, 14, and 28 days after training. RESULTS AND CONCLUSION:(1) There were no significant differences in baseline data and ankle function scores between two groups before training(P > 0.05), and all above indicators were significantly improved in both two groups at 4 weeks after training(P < 0.05).(2) Compared with the control group, the muscle strength, Kofoed ankle score and visual analogue scale scores on computer in the experimental group were significantly improved at 7, 14 and 28 days after training(P < 0.05).(3) The active plantar flexion angle in the experimental group was significantly larger than that in the control group at 28 days after training(P < 0.05).The active plantar flexion and dorsiflexion angles at 7 and 14 days after training, and active dorsiflexion angle at 28 days after training did not differ significantly between two groups(P > 0.05). To conclude, the unique ankle-foot orthosis can reduce postoperative pain, enhance muscle strength and improve ankle mobility after ankle fracture.更多还原