步行机器人训练对慢性期脑卒中偏瘫患者步行能力的影响  

Robot-assisted gait training improves the walking ability of stroke survivors

作　　者：张旭[1] 邱模炎[1] 权范善 吴东宇[1] 李媛媛 段国平[1] 田静峰[1] 何龙[1] 白雪竹 朱立国[1] Zhang Xu;Qiu Moyan;Bum Sun Kwon;Wu Dongyu;Li Yuanyuan;Duan Guoping;Tian Jingfeng;He Long;Bai Xuezhu;Zhu Liguo(Department of Rehabilitation,Wangjing Hospital of the Chinese Academy of Chinese Medical Science,Beijing 100102,China;Department of Rehabilitation,Yushan Hospital of Dongguk University,Korea 410-773)

机构地区：[1]中国中医科学院望京医院康复科,北京100102 [2]韩国东国大学附属一山医院康复科,韩国410-773

出　　处：《中华物理医学与康复杂志》2021年第1期30-33,共4页Chinese Journal of Physical Medicine and Rehabilitation

基　　金：中医药国际合作专项(GZYYGJ2018032);中国中医科学院“十三五”重点领域项目(ZZ10-015);国家自然科学基金(81171011、81572220);首都临床特色应用研究(Z121107001012144、Z171100001017111);国家中医药管理局课题(GZT-KJS-2017-10)。

摘　　要：目的探讨步行机器人训练对慢性期脑卒中偏瘫患者步行能力的影响。方法将40例符合纳入标准的脑卒中患者应用随机数字表法按1∶1比例分为对照组和机器人组,每组20例。研究过程中,机器人组因陪护原因没有完成初始干预而脱落2例,其余患者均完成了初始2周治疗;2组患者中有23例患者完成全部4周的治疗。所有患者均接受常规康复治疗,对照组在此基础上给予治疗师徒手步行训练,机器人组在常规康复治疗的基础上接受步行机器人(Exowalk)训练,每日训练60 min,每周5 d,共4周。分别于治疗前及治疗2周后和治疗4周后,采用功能性步行分级(FAC)、Berg平衡(BBS)、6 min步行测试(6MWT)、10 m步行测试(10MWT)、Rivermead移动指数(RMI)、运动指数(MI)对2组患者的步行能力进行评估。结果治疗2周后,2组患者的FAC、BBS、6MWT、10MWT等指标均较组内治疗前有显著改善(P<0.05),而组间差异并无统计学意义(P>0.05)。治疗4周后,机器人组的BBS由(33.92±20.83)分增长到(37.92±18.61)分,差异有统计学意义(P<0.025);2组间对比,各指标差异均无统计学意义(P>0.05),但机器人组的FAC由(3.69±1.43)分增长到(4.15±1.34)分,呈持续上升趋势,而对照组FAC的在治疗2周后无明显变化。结论步行机器人能持续改善慢性期脑卒中偏瘫患者的平衡功能,提高患者步行能力。Objective To explore the effectiveness of the Exowalk gait training robot in improving the walking ability of stroke survivors.Methods Forty stroke survivors were randomly divided into a control group and an experimental group,each of 20.In their rehabilitation,the control group was given routine walking training,while the experimental group′s training was assisted with the Exowalk robot.Both groups trained for 60 minutes a day,five days a week for four weeks.Before as well as after 2 and 4 weeks of training functional ambulatory categories(FACs),the Berg balance scale(BBS),the 6-minute walking test(6MWT),the 10-minute walking test(10MWT),the Rivermead mobility index and an exercise index were used to evaluate those in both groups.Results After 2 weeks significant improvement was observed in the average FAC,BBS,6MWT and 10MWT results of both groups,without significant differences between them.After 4 weeks there was still no significant difference in the groups′average BBS scores.However,the average FAC rating in the experimental group had improved significantly while there was no significant increase in the control group′s average score.Conclusions The Exowalk robot can help to improve the balance and walking ability of hemiplegic stroke survivors.

关 键 词：康复机器人 脑卒中 偏瘫 下肢运动功能 平衡 

分 类 号：R743.3[医药卫生—神经病学与精神病学] TP242[医药卫生—临床医学]