腰椎管狭窄平衡功能的足底压力分析△

Plantar pressure analysis on balance function in lumbar spinal stenosis

摘要:

[目的] 对比分析具有神经源间歇性跛行 (neurogenic intermittent claudication, NIC) 症状的腰椎管狭窄症 (lumbar spinal stenosis, LSS) 患者与健康人群之间足底压力中心 (center of pressure, COP) 的差异，验证 COP 在客观评估 LSS 患者行走平衡功能方面的应用价值。[方法]选取 32 例 L4/5LSS 患者为 LSS 组，32 例健康成人作为健康人组，利用 Footscan?足底压力测试系统收集动态足底压力数据，通过比较 LSS 组与健康人组的 COP 位移和 COP 速度评估 LSS 患者的行走平衡功能。[结果] LSS 组前足触地期(forefoot contact phase, FFCP)以及全足触地期(foot flat phase, FFP)的 COP 位移和速度均较健康人组显著增加 (P＜0.05)，而足跟触地期 (initial contact phase, ICP) 和前足离地期 (forefoot push-off phase，FFPOP) 的 COP 位移和速度的差异均无统计学意义(P＞0.05)。[结论]LSS 患者 NIC 症状发作后其平衡功能显著受损，可以利用 FFCP 期和 FFP 期 COP 的位移和速度对 LSS 患者动态平衡功能进行客观评估。

Abstract:

[Objective] To compare and analyze the difference in the plantar center of pressure (COP) between patients with lumbar spi- nal stenosis (LSS) accompanied with neurogenic intermittent claudication (NIC) and healthy persons, and verify the application value of COP parameter in objectively evaluating the balance function in LSS. [Methods] A total of 32 patients with L4/5 LSS were selected as the LSS group, while the other 32 healthy adults at the same age were selected as the healthy group. Footscan? platform system was used to measure the plantar pressure of these subjects during walking. The balance function of LSS patients was evaluated by comparing the center of pressure (COP) displacement and COP velocity between the two groups. [Results] The COP displacement and velocity of the LSS group during the forefoot contact phase (FFCP) and the foot flat phase (FFP) were significantly higher than those of the control group (P＜0.05) , whereas no significant differences in COP displacement and velocity were observed between the two groups during the initial contact phase (ICP) and forefoot push-off phase (FFPOP) . [Conclusion] The balance function of LSS patients after the occurrences of NIC is significantly damaged. Using the displacement and velocity of COP during the FFCP and FFP might achieve an objective assessment of the dynamic bal- ance function of LSS patients.