下肢外骨骼机器人康复训练对脑卒中偏瘫患者下肢运动的影响  

Effects of lower limb exoskeleton robot rehabilitation training on lower limb motion of hemiplegic patients after stroke

作　　者：李希 王秉翔[3] 李娜 曹丽娜[1] 李爱华 冠潇[1] 张志勉[1] LI Xi;WANG Bingxiang;LI Na;CAO Lina;LI Aihua;GUAN Xiao;ZHANG Zhimian(Department of Health Management Center,Qilu Hospital of Shandong University,Jinan 250012,Shandong,China;Department of Health Management,Jining No.1 People’s Hospital,Jining 272000,Shandong,China;Department of Spine Surgery,Shandong Provincial Hospital,Jinan 250021,Shandong,China;Department of Rehabilitation Medicine,Jinan Hospital Jinan 250013,Shandong,China)

机构地区：[1]山东大学齐鲁医院健康管理中心,山东济南250012 [2]济宁市第一人民医院保健病房,山东济宁272000 [3]山东省立医院脊柱外科,山东济南250021 [4]济南医院康复医学科,山东济南250013

出　　处：《山东大学学报（医学版）》2023年第3期121-126,133,共7页Journal of Shandong University:Health Sciences

基　　金：山东省重大科技创新工程项目(2019JZZY011110)。

摘　　要：目的探讨下肢外骨骼机器人康复训练对脑卒中偏瘫患者下肢运动功能的影响。方法收集54例发病12个月内的脑卒中偏瘫患者,分为试验组27例和对照组27例。对照组患者进行常规康复训练及步行训练,试验组患者进行常规康复训练及下肢外骨骼机器人步行训练。分别于治疗前、治疗2周后和治疗4周后予以步行功能评估,包括6 min步行试验(6MWT)、10 m步行测试(10MWT)和功能性步行分级(FAC);Fugl-Meyer下肢运动评定量表(FMA-LE)评估下肢运动功能;使用运动捕捉系统采集患者的步态时空参数。通过以上各项指标分析两组患者下肢运动功能的变化情况。结果(1)治疗2周和4周后,试验组和对照组患者6MWT、10MWT组内较治疗前均有明显提高,差异有统计学意义(P均<0.05);治疗4周后,两组患者6MWT与治疗2周组内相比有进一步提高,差异有统计学意义(P均<0.001),仅试验组患者10MWT组内较治疗2周比较,差异有统计学意义(P=0.0085);(2)治疗2周和4周后,试验组和对照组FAC评级和FMA-LE评分组内较治疗前相比有明显改善,差异有统计学意义(P均<0.01),两组治疗4周后FMA-LE较2周时有更进一步改善,差异有统计学意义(P均<0.001);(3)治疗4周后,试验组步行周期较治疗前(P=0.0035)、2周后(P=0.0032)相比,差异有统计学意义。结论下肢外骨骼机器人可有效改善脑卒中偏瘫患者的下肢运动功能、步行功能和步行周期,其疗效与常规步行训练相当。Objective To explore the effects of lower limb exoskeleton robot rehabilitation training on lower limb motor function of hemiplegic patients after stroke.Methods A total of 54 patients with stroke hemiplegia within 12 months of onset were randomly divided into the test group(n=27)and control group(n=27).The control group received routine rehabilitation training and walking training,while the test group received routine rehabilitation training combined with lower limb exoskeleton robot rehabilitation training.Walking function was assessed before,2 weeks and 4 weeks after training.The 6 minute walking test(6MWT),10 meter walking test(10MWT),functional ambulation category(FAC),and Fugl-Meyer assessment for lower extremity(FMA-LE)were used to assess the lower extremity motor function.Gait analysis was collected by using the motion capture system.Results(1)After 2 and 4 weeks of training,the 6MWT and 10MWT of both groups were significantly improved(P<0.05);after 4 weeks of training,the 6MWT of both groups was further improved compared with that of 2 weeks(P<0.001);the 10MWT of the test group was significantly improved compared with that of 2 weeks(P=0.0085).(2)After 2 and 4 weeks of training,FAC and FMA-LE in both groups were significantly improved(P<0.01);FMA-LE in the two groups was further improved after 4 weeks of training compared with that of 2 weeks(P<0.001).(3)After 4 weeks of training,the gait cycle of the test group was significantly improved compared with that before training(P=0.0035)and 2 weeks of training(P=0.0032).Conclusion The lower limb exoskeleton robot can effectively improve the lower limb motor function,walking function and walking cycle,and its effect is equivalent to that of conventional walking training.

关 键 词：下肢外骨骼机器人 康复训练 脑卒中 偏瘫 步行功能 步态 

分 类 号：R493[医药卫生—康复医学]