平地行走式下肢外骨骼机器人对脑卒中患者步行功能的影响  

An exoskeleton robot can help improve the walking ability of stroke survivors

作　　者：陈芳[1] 季晶[2] 苏彬 邱怀德 吴希希[4] 黄颖珺 黄思思[2] 张宇婷[2] 王雪[2] 万春利[2] 葛盼丽 黄俊豪 李勇强[1,2] Chen Fang;Ji Jing;Su Bin;Qiu Huaide;Wu Xixi;Huang Yingjun;Huang Sisi;Zhang Yuting;Wang Xue;Wang Chunli;Ge Panli;Huang Junhao;Li Yongqiang(Nanjing Sport Institute,Nanjing 210014,China;The First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China;Wuxi Tongren Rehabilitation Hospital,Wuxi 214150,China;Zhongshan Rehabilitation Hospital Affiliated to Jiangsu Province Hospital,Nanjing 210046,China)

机构地区：[1]南京体育学院,南京210014 [2]南京医科大学第一附属医院,南京210029 [3]无锡市同仁康复医院,无锡214150 [4]江苏省人民医院钟山康复分院,南京210046

出　　处：《中华物理医学与康复杂志》2022年第6期497-502,共6页Chinese Journal of Physical Medicine and Rehabilitation

基　　金：南京市科学技术局(2019060002);无锡"太湖人才计划"医疗卫生高层次人才项目(WXTTP2020008);江苏省研究生科研与实践创新计划(KYCX21_1976)。

摘　　要：目的观察平地行走式下肢外骨骼机器人训练对脑卒中患者步行功能的疗效。方法按随机数字表法将58例脑卒中患者分为机器人组(29例)和对照组(29例)。对照组给予常规康复治疗联合常规步行训练,机器人组则给予常规康复治疗联合外骨骼机器人步行训练。2组患者的步行训练均为每日2次,每次30 min,每周训练5 d,连续每次4周。于治疗前、治疗2周和4周后对2组患者的步行能力[包括6 min步行测试(6MWT)和功能性步行分级(FAC)]和下肢运动功能[Fugl-Meyer下肢运动评定量表(FMA-LE)]进行评估,并于治疗前和治疗4周后检测2组患者的步态。结果治疗2周和4周后,2组患者的6MWT较组内治疗前均明显提高,差异均有统计学意义(P<0.01)。机器人组治疗2周后与组内治疗前的6MWT差值与对照组比较,差异有统计学意义(P=0.034)。治疗2周和4周后,2组患者的FMA-LE和FAC较组内治疗前均显著改善,差异均有统计学意义(P<0.01)。治疗4周后,2组患者的步频和步态周期与组内治疗前比较,差异均有统计学意义(P<0.01)。结论平地行走式下肢外骨骼机器人训练可改善脑卒中患者的步行能力和下肢运动功能,其疗效与常规步行训练相当。Objective To explore the efficacy of a flat ground exoskeleton robot in improving the walking ability of stroke survivors.Methods Fifty-eight stroke survivors with mobility difficulties were randomly divided into a robot group(n=29)and a control group(n=29).In addition to routine rehabilitation,the control group received conventional walking training,while the robot group underwent exoskeleton robot-assisted gait training.The 30-minute training sessions were held twice a day,5 days per week for 5 weeks.Before as well as after 2 and 4 weeks of treatment,everyone′s walking ability was tested using the 6-minute walk test(6MWT)and functional ambulation scale(FAC).General lower limb motor function was quantified using the Fugl-Meyer Lower Extremity assessment(FMA-LE).Moreover,gait analysis was conducted before and after 4 weeks of treatment.Results After 2 and 4 weeks of treatment,the average 6MWT times of both groups were significantly better than before the treatment,with the improvement of the robot group significantly greater than that of the control group after 2 weeks.After 2 and 4 weeks the average FMA-LE and FAC scores of both groups had improved significantly compared with before treatment.After 4 weeks the stride frequency and gait cycle of both groups had improved significantly.Conclusions Exoskeleton robot-assisted gait training can improve walking ability and lower limb motor function of stroke survivors about as well as conventional walking training.

关 键 词：下肢外骨骼机器人 脑卒中 步行训练 下肢运动功能 康复 

分 类 号：R743.3[医药卫生—神经病学与精神病学]