康复机器人训练对脑卒中偏瘫上肢功能及神经电生理的影响  

Nerve electrophysiology and hemiplegic upper-limb function with robot-assisted training on upper-limb in stroke patients

作　　者：王会才[1] 赵凯[1] 葛玥[1] 

机构地区：[1]安徽医科大学第一附属医院康复医学科,安徽合肥230022

出　　处：《安徽医药》2014年第9期1690-1694,共5页Anhui Medical and Pharmaceutical Journal

摘　　要：目的观察康复机器人对脑卒中偏瘫患者上肢功能恢复疗效及上肢神经传导速度的影响。方法将60例患者随机分为试验组和对照组,每组各30例。对照组给予常规肢体功能训练,包括运动疗法(PT)和作业治疗(OT)治疗等;试验组除给予常规肢体功能训练外,还进行上肢康复机器人治疗。入选患者分别于训练前、训练2 w、训练4 w后接受以下评定:(1)肩、肘、腕活动度(ROM)及手握力;(2)Lindmark评分;(3)上肢神经传导速度检测。结果治疗前,两组患者肩、肘、腕活动度(ROM)及手握力、Lindmark评分、上肢神经传导速度评分结果比较差异无统计学意义(P>0.05)。训练4 w后,两组患者的肩、肘、腕活动度(ROM)、Lindmark评分、上肢神经传导速度评分结果:试验组和对照组均较训练前有改善(P<0.05),部分有显著改善(P<0.01);试验组与对照组比较:在肩外展、肩前屈、肘屈、前臂旋前、前臂旋后、Lindmark评分和上肢神经传导速度上,试验组均优于对照组(P<0.05),在手握力、肩内收上,试验组明显优于对照组(P<0.01)。结论上肢康复机器人结合常规肢体功能训练能更有效地促进脑卒中偏瘫患者上肢功能的恢复,并更有效地改善偏瘫侧上肢神经的传导功能。Objective To observe the rehabilitation efficacy of stroke patients with robot-assisted training including upper limb function and nerve conduction velocity. Methods Sixty cases were randomized into control group and experiment group, thirty cases in each group. The control group was given conventional upper-limb function training, including physical therapy （PT） and occupational therapy （OT） ,while the experiment group was given conventional upper-limb function training and robot-assisted training for upper-limb. The patients in both groups were treated for thirty minutes once a day, five times a week,with four weeks as one period of treatment. Assess- ments were made among patients before training, two weeks and four weeks after training, including shoulder, elbow, wrist range of motor （ROM） and hand grip strength, Lindmark scores, nerve conduction velocity （ NCV ） of the upper-limb. Results Before training, there were no statistical differences in the shoulder, elbow, wrist ROM, hand grip strength, NCV and Lindmark scores of the upper-limb be- tween the two groups （ P 〉 0.05 ） , but four weeks after training, the experiment group gained better scores than the control group （ P 〈 0.05 ）, and some scores had improved significantly（ P 〈 0.01 ）. The experiment group was better than the control group in the shoulder, elbow, wrist ROM and NCV of upper-limb（ P 〈 0.05 ）, and had improved significantly in the hand grip strength and Lindmark scores （P 〈 0. O1 ）. Conclusions It could be concluded that robot-assisted training gained better motor function of upper limb in stroke patients on the basis of conventional training, and more effectively improve the nerve conduction function of hemiplegic upper limb.

关 键 词：康复机器人 脑卒中 偏瘫上肢 神经传导速度 

分 类 号：TP242[自动化与计算机技术—检测技术与自动化装置]