基于踝关节康复机器人的临床应用效果观察  

Observation on clinical application effect of ankle rehabilitation robot

作　　者：吕星[1] 王玉龙[1] 龙建军[1] 李小萍[1] 万力 余飞 LV Xing;WANG Yu-long;LONG Jian-jun;LI Jian-ping;WAN Li;YU Fei(Department of Rehabilitation Medicine, Shenzhen second people's Hospital,518035, China)

机构地区：[1]深圳市第二人民医院康复医学科,广东深圳518035

出　　处：《海南医学院学报》2020年第10期787-790,795,共5页Journal of Hainan Medical University

基　　金：广东省医学科学技术研究基金项目(A2017250)。

摘　　要：目的:研究踝关节康复机器人对偏瘫患者关节运动的辅助干预效果,并进行定量化评价。方法:选择在本院接受治疗的90例下肢功能障碍的偏瘫患者作为研究对象。随机分为对照组与观察组,每组各45例。两组均接受语言训练、理疗、运动疗法、水疗、作业疗法、推拿等综合性康复治疗,观察组在此基础上接受踝关节康复机器人的辅助干预。治疗前后采用踝关节跖屈力矩评价患者的软组织顺应性,采用改良Tardieu量表评价患者的跖屈肌张力,采用踝主动踝背伸活动度评价临床疗效。结果:与治疗前相比,治疗后两组踝关节各背屈角度(0°、10°、20°、30°)下跖屈肌对抗力矩明显降低(P<0.05),并且观察组明显低于对照组(P<0.05);与治疗前相比,治疗后两组踝跖屈肌群改良Tardieu量表评测的R1、R2角度明显增加,R2-R1差值明显减小(P<0.05),并且观察组改善程度明显优于对照组(P<0.05);与治疗前相比,治疗后两组主动踝背伸活动度明显增加(P<0.05),且观察组治疗总有效率明显大于对照组(P<0.05)。结论:采用踝关节康复机器人系统进行辅助干预治疗,能在短期内有效提高痉挛型偏瘫踝关节软组织顺应性,减轻跖屈肌的挛缩状态,改善关节运动障碍,同时患者及其家属的配合度和接受度较高,是一种行之有效的提升治疗效果的手段。Objective The effect of ankle rehabilitation robot on joint movement of hemiplegic patients was studied and quantitatively evaluated.MethodsTotally 90 hemiplegic patients with lower limb dysfunction treated in our hospital from April 2017 to March 2019 were selected as subjects.The patients were randomly divided into control group(n=45)and observation group(n=45).The patients in the two groups received language training,physiotherapy,exercise therapy,spa,occupational therapy,massage and other comprehensive rehabilitation treatment,on the basis of which the observation group received the auxiliary intervention of ankle rehabilitation robot.The soft tissue compliance of the patients was evaluated by ankle metatarsal flexion moment before and after treatment,the metatarsal flexor tension was evaluated by modified Tardieu scale,and the clinical effect was evaluated by ankle active ankle dorsiflexion.Results After treatment,the ankle flexion angles(0°,10°,20°,30°)in the two groups were significantly lower than those in the control group(P<0.05).Compared with before treatment,the ankle flexion angles(0°,10°,20°,30°)in the two groups were significantly lower than those in the control group(P<0.05).After treatment,the angle of R1 and R2 measured by modified Tardieu scale of ankle plantar flexor group increased significantly,and the difference of R2-R1 decreased significantly(P<0.05).The improvement degree of the observation group was significantly better than that of the control group(P<0.05).After treatment,the active ankle extension activity of the two groups was significantly higher than that before treatment(P<0.05),and the effective rate of the observation group was significantly higher than that of the observation group(P<0.05).Conclusion Auxiliary intervention with ankle rehabilitation robot system can effectively improve the compliance of ankle soft tissue in spastic hemiplegia,reduce the contracture of metatarsal flexor muscle and improve the disturbance of joint movement in a short time.At the same time

关 键 词：踝关节 康复机器人 偏瘫 改良Tardieu量表 康复定量研究 

分 类 号：R493[医药卫生—康复医学] R684[医药卫生—临床医学]