上肢康复机器人在脑卒中上肢屈肌痉挛患者肘伸展功能恢复中的应用效果  

Effect of upper limb rehabilitation robot on the recovery of elbow extension function in stroke patients with upper limb flexor spasm

作　　者：朱琳[1] 席艳玲[1] 严会荣[1] 陈祢[1] 黄海霞[1] ZHU Lin;XI Yan-ling;YAN Hui-rong(Department of Rehabilitation medicine,the First Affiliated Hospital of Xinjiang Medical University,Urumqi Xinjiang 830000,China)

机构地区：[1]新疆医科大学第一附属医院康复医学科,新疆乌鲁木齐830000

出　　处：《临床和实验医学杂志》2022年第10期1110-1114,共5页Journal of Clinical and Experimental Medicine

基　　金：新疆维吾尔自治区自然科学基金资助项目(编号:2017D01C333)。

摘　　要：目的探讨上肢康复机器人在脑卒中上肢屈肌痉挛患者肘伸展功能恢复中的应用效果。方法采用回顾性分析,将2017年2月至2018年12月在新疆医科大学第一附属医院行常规肢体康复训练的43例脑卒中上肢屈肌痉挛患者作为对照组,2019年1月至2020年5月本院在常规肢体康复训练基础上采用上肢康复机器人训练的44例脑卒中上肢屈肌痉挛患者作为观察组。统计分析两组患者治疗前后日常生活能力量表(ADL)评分、肢体运动功能量表(FFMA-UM)以及改良Ashworth痉挛量表(MAS)、肘关节主动伸展角度、肱二、三头肌肌电积分(iEMG)及协同收缩率比较。结果干预后,两组患者ADL和FMA-UM评分同组内与干预前比较,均上升,MAS评分均下降,观察组患者ADL和FMA-UM评分为(51.36±7.03)、(34.71±4.07)分,均高于对照组[(44.58±5.70)、(27.52±3.05)分],观察组MAS评分为(2.12±0.29)分,低于对照组[(3.19±0.35)分],差异均有统计学意义(P<0.05)。干预后,两组患者肘关节伸展角度、肱二、三头肌iEMG同组内与干预前比较,均升高,观察组肘关节伸展角度为(48.52±6.14)°大于对照组[(32.15±4.03)°],肱二、三头肌iEMG为(276.39±40.38)、(37.51±8.36)mV/s,高于对照组[(223.51±44.68)、(31.69±7.09)mV/s],差异均有统计学意义(P<0.05)。干预后,两组患者肱二、三头肌协同收缩率同组内与干预前比较,均降低,观察组患者肱二、三头肌协同收缩率为(15.36±2.16)%、(27.06±3.65)%,小于对照组[(17.26±2.09)%、(34.69±4.09)%],差异均有统计学意义(P<0.05)。结论脑卒中上肢屈肌痉挛患者在常规肢体康复训练基础上采用上肢康复机器人的治疗后具有较好的治疗效果,减轻上肢运动功能障碍,缓解肌肉痉挛,增加肘关节伸展功能。Objective To investigate the effect of upper limb rehabilitation robot in the recovery of elbow extension function in stroke patients with upper limb flexor spasm.Methods By retrospective analysis,43 patients with stroke upper limb flexor spasm treated in the First Affiliated Hospital of Xinjiang Medical University from February 2017 to December 2018 were selected as the control group,and conventional limb rehabilitation training was used.By retrospective analysis,44 patients with stroke upper limb flexor spasm treated in the First Affiliated Hospital of Xinjiang Medical University from January 2019 to may 2020 were selected as the observation group,and upper limb rehabilitation robot training was used on the basis of the control group.the Activity DailyScale(ADL)score,Fugel-MeyerAssessment(FMA-UM)and Modified Ashworth Spasm Scale(MAS),elbow active extension angle,biceps and triceps integrsted electromyography threshold(iEMG)comparison and synergistic contraction rate comparison were recorded before and after treatment in both groups.Results After the intervention,the ADL and FMA-UM scores of the two groups increased and the MAS scores decreased compared with those before the intervention,but the ADL and fma-um scores of the observation group were(51.36±7.03)points,(34.71±4.07)points,which were higher than those of the control group[(44.58±5.70)points,(27.52±3.05)points],and the MAS scores of the observation group were(2.12±0.29)points,which were lower than those of the control group[(3.19±0.35)points],the differences were statistically significant(P<0.05).After the intervention,the elbow extension angle of the two groups increased compared with that before the intervention,but the elbow extension angle of the observation group was(48.52±6.14)°,which was greater than that of the control group[(32.15±4.03)°],the differences were statistically significant(P<0.05).After the intervention,the iEMG of biceps brachii and triceps brachii in the two groups increased compared with that before the intervention,but

关 键 词：脑卒中 上肢康复机器人 上肢屈肌痉挛 肘伸展功能 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R496[医药卫生—临床医学]