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孔雨柔,刘 林,焦 乐,李汶汶,林 枫,江钟立.维持性血液透析患者的步态特征及其影响因素[J].中国康复医学杂志,2021,(7):816~821
维持性血液透析患者的步态特征及其影响因素    点此下载全文
孔雨柔  刘 林  焦 乐  李汶汶  林 枫  江钟立
南京医科大学第一临床医学院,江苏南京,210029
基金项目:南京医科大学附属逸夫医院院内临床重点科室建设专项(YFZDXK02-7)
DOI:10.3969/j.issn.1001-1242.2021.07.009
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摘要:
      摘要 目的:探讨维持性血液透析(maintenance hemodialysis,MHD)患者的步态特征及其可能的影响因素,为临床制定针对性康复治疗方案预防跌倒提供参考依据。 方法:本研究招募了MHD患者19例和健康志愿者21例,MHD患者于透析日和非透析日各行一次步行测试,健康对照组则随机进行一次步行测试。使用无线APDM运动监测惯性传感器系统采集步态时空参数(步速、步幅、首次触地角、足趾离地角、步频、步态周期),采用慢性病治疗功能评估-疲劳量表(the functional assessment of chronic illness therapy-fatigue,FACIT-F)评估MHD患者最近一周的疲劳程度。 结果:MHD患者透析日和非透析日的步速、步幅、足趾离地角均显著小于对照组(P<0.05),且均与FACIT-F得分显著正相关(P<0.05)。在透析日,MHD患者的步频显著小于对照组(P<0.05),步态周期则显著大于对照组(P<0.05)。在MHD患者中,透析日的步速、步幅和足趾离地角均显著小于非透析日(P<0.05)。 结论:MHD患者存在步态参数异常,血透后步态参数的异常较血透前更显著。慢性疲劳状态可能是MHD患者步态参数异常的影响因素。
关键词:维持性血液透析  跌倒  步态分析  足趾离地角  疲劳
The characteristics and influencing factors of gait in maintenance hemodialysis patients    Download Fulltext
The First Affiliated Hospital with Nanjing Medical University,Nanjing,210029
Fund Project:
Abstract:
      Abstract Objective: To explore the characteristics and influencing factors of gait in maintenance hemodialysis (MHD) patients, and to provide reference for clinical development of rehabilitation treatments to prevent falls. Method: Nineteen MHD patients and twenty-one healthy volunteers were recruited in the study. In MHD patients, walking test was performed twice — once on a dialysis day and once on a non-dialysis day, and healthy controls randomly conducted a walking test. Gait spatiotemporal parameters (gait speed, stride length, initial contact angle, toe-off angle, cadence, and gait cycle duration) were collected using a wireless APDM movement monitoring inertial sensor system, and the fatigue degree of MHD patients were evaluated using the functional assessment of chronic illness therapy-fatigue (FACIT-F). Result: The gait speed, stride length and toe-off angle of MHD patients on a dialysis day and a non-dialysis day were significantly lower than control group (P<0.05), and were significantly positively correlated with FACIT-F score (P<0.05). The cadence of MHD patients was significantly lower than control group (P<0.05), and the gait cycle duration was significantly higher than control group (P<0.05) on a dialysis day. In MHD patients, gait speed, stride length and toe-off angle on a dialysis day were significantly smaller than on a non-dialysis day (P<0.05). Conclusion: MHD patients present with gait disorders, and gait impairment after hemodialysis was more significant than before hemodialysis. Chronic fatigue could be the factors leading to gait disorders in MHD patients.
Keywords:maintenance hemodialysis  falls  gait analysis  toe-off angle  fatigue
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