CAJ | 학술논문

背景：胸段脊髓损伤常导致双下肢截瘫，截瘫步行矫形器能帮助截瘫患者改善下肢功能障碍，提高日常生活活动能力，重获站立和行走能力。
배경：흉단척수손상상도치쌍하지절탄，절탄보행교형기능방조절탄환자개선하지공능장애，제고일상생활활동능력，중획참립화행주능력。
BACKGROUND:Thoracic spinal cord injury often leads to double lower limb paralysis. Paraplegia walking orthosis can improve lower limb dysfunction, improve the daily living activity, and regain the ability to stand and walk in patients with paraplegia. OBJECTIVE:To discuss the effects of paraplegia walking orthosis on muscle spasticity and recovery of function of the affected lower extremity in patients with thoracic spinal cord injury. METHODS:The 20 patients with thoracic spinal cord injury (T5-12), according to the damage plane by American Spinal Injury Association standard, were divided into complete damage group and incomplete damage group (n=10). Al patients were fitted out paraplegia walking orthosis. They received residual muscle strength training, sitting balance training, and transfer training prior to assembly, and then subjected to standing exercise within paralel bar, balance and transfer training, and walking aid devices training indoor and outdoor, and elbow crutch training on foot after the assembly. RESULTS AND CONCLUSION:Compared with pre-treatment, American Spinal Injury Association score increased at 12 weeks after treatment with paraplegia walking orthosis, and sensation did not obviously alter. Spasm worsened with prolonged course of disease in the complete damage group. At 12 weeks after treatment, American Spinal Injury Association score increased, sensation apparently improved, and the spasm did not change with time in the incomplete damage group. Activities of daily living (modified Barthel index, and functional independence evaluation) evidently improved in both groups. Compared with 2 weeks, the 10-m walking time was noticeably reduced and the 6-minute walking distance was prolonged at 12 weeks in both groups. These results confirm that paraplegia walking orthosis fitted out in patients with thoracic spinal cord injury significantly improves the patient’s motor function, activities of daily living and walking ability, and also has certain influence on muscle spasm control.