| 康思敏,赵 秦,曲玉娟,张 杨,魏 慧,岳寿伟.骶裂孔注射治疗对腰椎间盘突出症患者步态的影响[J].中国康复医学杂志,2023,(1):28~34 |
| 骶裂孔注射治疗对腰椎间盘突出症患者步态的影响 点此下载全文 |
| 康思敏 赵 秦 曲玉娟 张 杨 魏 慧 岳寿伟 |
| 山东大学齐鲁医院康复科，山东省济南市，250012 |
| 基金项目：山东省重点研发计划（重大研发创新工程）项目（2019JZZY011112） |
| DOI：10.3969/j.issn.1001-1242.2023.01.005 |
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| 摘要： |
| 摘要
目的：利用三维步态分析系统定量分析骶裂孔注射治疗对腰椎间盘突出症患者的疗效，为骶裂孔注射治疗腰椎间盘突出症提供科学依据，为各种步行相关功能障碍疾病的康复疗效评定提供新思路。
方法：共纳入20例腰椎间盘突出症（lumbar disc herniation，LDH）患者，分别在骶裂孔注射前、第1次骶裂孔注射1周后、第2次骶裂孔注射1周后对20例患者进行Oswestry功能障碍指数（Oswestry disability index，ODI）评分、下腰痛JOA（Japanese Orthopaedic Association）评分、R-M腰椎功能问卷（Roland-Morris）评分及视觉模拟评分法（visual analogue scale/score， VAS）；要求患者以舒适的速度在平地上规定的路线内行走5m以上的距离，共行走4次，利用三维步态分析系统采集所有患者的运动学数据。采用SPSS 26.0软件对患者的量表评分及运动学数据进行统计学分析。
结果：腰椎间盘突出症患者经骶裂孔注射治疗后，Oswestry功能障碍指数问卷表总分较治疗前增加，JOA评分、中文版R-M评分及VAS评分均较治疗前减小（P＜0.05），且第2次骶裂孔注射治疗后较第1次治疗后好转（P＜0.05）；患者的步态数据包括步长、跨步长、步行周期、步速、支撑相百分比、髋关节屈伸活动范围（ROM）、膝关节屈曲活动范围（ROM）、踝关节屈伸活动范围（ROM），以及关节运动速度均较治疗前好转（P＜0.05），且第2次骶裂孔注射治疗后距离及时间参数较第1次治疗后好转更为显著（P＜0.05），但时空参数在第2次治疗后无明显改善（P＞0.05）；此外，患者在治疗前后关节活动速度与VAS评分之间存在显著相关（P＜0.05）。
结论：骶裂孔注射治疗可明显缓解腰椎间盘突出症患者疼痛，进一步改善患者步态，提高患者的生活质量。 |
| 关键词：腰椎间盘突出症 三维步态分析 骶裂孔注射治疗 |
| Effects of sacral hiatus injection on gait in patients with lumbar disc herniation Download Fulltext |
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| Dept. of Physical Medicine and Rehabilitation，Qilu Hospital of Shandong University，Jinan，250012 |
| Fund Project: |
| Abstract: |
| Abstract
Objective： To quantitatively analyze the curative effect of sacral hiatus injection in patients with lumbar disc herniation by using three-dimensional gait analysis system， and to provide scientific basis for the sacral hiatus injection in the treatment of lumbar disc herniation， and to provide new ideas for the evaluation of rehabilitation effect of various walk-related dysfunction diseases.
Method： A total of 20 patients with lumbar disc herniation (LDH) were enrolled and tested with Oswestry disability index (ODI) scores， Japanese Orthopaedic Association (JOA) scores， Roland Morris scores and VAS scores before sacral hiatus injection， 1 week after the first sacral hiatus injection and 1 week after the second sacral hiatus injection.The patients were required to walk at a comfortable speed of more than 5 meters within the prescribed route on the flat ground for a total of 4 times， and the kinematics data of all patients were collected by using the three-dimensional gait analysis system. SPSS 26.0 software was used to statistically analyze the scale scores and kinematics data of the patients.
Result： After the sacral hiatus injection， the total score of the ODI was increased， the JOA score， Chinese R-M score and VAS score were decreased (P<0.05)， and the score after the second sacral hiatus injection was improved compared with the first treatment (P<0.05).The patient's gait data including step length， stride length， walking cycle， percentage of pace and support phase， Range of motion (ROM) of hip flexion， Range of motion (ROM) of knee flexion， Range of motion (ROM) of ankle flexion and joint movement speed was improved(P<0.05)， The distance and time parameters after the second sacral hiatus injection were improved more significantly than those after the first treatment(P<0.05)， but the spatio-temporal parameters did not improve significantly after the second treatment(P>0.05)； In addition， there was a significant correlation between the joint movement speed and VAS score before and after treatment(P<0.05).
Conclusion： Sacral hiatus injection therapy can significantly relieve the pain of patients with lumbar disc herniation， further improve the gait and the quality of life of them. |
| Keywords:lumbar disc herniation three dimensional gait analysis sacral hiatus injection |
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