运用三维步态分析评价下肢机器人训练对偏瘫患者步行能力的影响  

Robot-assisted gait training improves the walking ability of hemiplegic patients

作　　者：朱童[1] 冯玲[1] 吴月峰[1] 高海军[1] 唐邵威 许夏彬 朱海平[1] 何贤杰[1] 章一锋 

机构地区：[1]浙江省绍兴市人民医院康复医学科,绍兴312000

出　　处：《中华物理医学与康复杂志》2017年第4期267-271,共5页Chinese Journal of Physical Medicine and Rehabilitation

基　　金：浙江省中医药（中西医结合）重点学科资助项目（2012-XK-A33）;浙江省中医药科学研究基金计划（A类）（2013ZA124）;浙江省医药卫生一般研究项目计划（A类）（2013KYA206）

摘　　要：目的应用三维步态分析评价下肢机器人训练对脑卒中偏瘫患者步行功能的影响。方法采用随机数字表法将60例脑卒中偏瘫患者分为观察组及对照组，两组30例。2组患者均给予常规药物治疗及康复干预，对照组同时辅以传统下肢步行训练，观察组则辅以下肢机器人训练。2组患者下肢训练时长均为每次30min，每周训练5d。于治疗前、治疗8周后分别采用三维步态分析系统检测2组患者步态时间参数、时相参数、关节活动角度及地面反作用力大小等指标。结果观察组患者经下肢机器人辅助训练后，其步速[（59．34±12．20）cm／s]、步频[（89．39±13．80）次／分钟]、跨步长[（74．17±15．54）cm]提高，步宽[（18．69±3．16）cm]缩小；患侧支撑期百分比[（69．72±10．06）％]、健侧与患侧支撑期比值（1．07±0．11）、双支撑期百分比[（16．85±8．23）％]、髋关节最大活动度[（35．39±9．31）。]、膝关节最大活动度[（50．21±15．34）°]、垂直地面反作用力峰值占体重百分比[（109．36±13．28）％]、患侧向前地面反作用力峰值占体重百分比[（6．95±1．98）％]均明显改善，与治疗前及对照组间差异均具有统计学意义（均P〈0．05）。结论与传统步行训练比较，下肢机器人训练能更有效改善脑卒中偏瘫患者步行功能，该疗法值得临床推广、应用。Objective To evaluate the effect of robot-assisted gait training on the walking ability of hemiplegic patients. Methods Sixty hemiplegie patients were randomly divided into a control group and a treatment group, each of 30. Both groups were given traditional rehabilitation and drug therapy. The control group was additionally provided with the traditional gait training, while the treatment group additionally received robot-assisted gait training. The gait training lasted 30 minutes a day, 5 days per week. Before and after 8 weeks of training, the time parameters, phase parameters, the joint angles of the lower limbs, and the peak ground reaction forces of both groups were evaluated using a three-dimensional gait analysis system. Results After the intervention, the walking velocity, stride frequency and stride length had increased in the treatment group, while stride width had decreased. Significant improvement was observed in the treatment group in terms of the percentage of swing phase on the paretic side, the percentage of stance phase on the paretie side, the single support time ratio, the percentage of double support phase, the range of motion of the hip and knee joints, and the peak vertical and forward ground reaction force as a percentage of body weight. The improvements were significantly greater than those observed in the control group. Conclusions Compared with traditional walking training, robot-assisted gait training can be more effective in improving the walking ability of hemiplegic patients.

关 键 词：下肢机器人 步行能力 三维步态分析 步态 

分 类 号：R493[医药卫生—康复医学] R743.3[医药卫生—临床医学]