机器人辅助步态训练对卒中后患者大脑功能重组及下肢功能影响的研究  

Study on the effects of robot-assisted gait training on the reorganization of brain function and the functions of lower limbs after stroke

作　　者：田苗 许济 游芳 陈斌 姜照伟 王春阳 李仕林 TIAN Miao;XU Ji;YOU Fang(Department of Rehabilitation medicine,The 3201 Hospital of Hanzhong,Hanzhong 72300,China;不详)

机构地区：[1]汉中市三二〇一医院康复医学科,陕西汉中723000 [2]西安市第三人民医院神经内科,陕西西安710000

出　　处：《中国医学装备》2023年第10期128-132,共5页China Medical Equipment

基　　金：陕西省科技计划[2019115113YX006SF039(4)]“机器人辅助步态训练对卒中后大脑功能重组及下肢功能影响的研究”。

摘　　要：目的:探讨机器人辅助步态训练对卒中后患者大脑功能重组及下肢功能影响。方法:选取医院收治的80例卒中后行康复治疗患者,按随机数表法将其分为观察组和对照组,每组40例。对照组患者接受常规康复训练,观察组患者在常规康复的基础上联合使用机器人辅助步态训练。干预前后采用弥散张量成像(DTI)检查评估大脑各向异性(FA)值,采用傅格梅尔运动功能下肢评定量表(FMA-LE)评分、6 min步行距离(6 MWD)和10 m步行时间评估下肢功能恢复情况。比较两组患者干预前后上述参数改变情况。结果:干预后,观察组患者健侧FA值显著高于干预前(t=5.330,P<0.05),且观察组患者干预后健侧FA值显著高于对照组(t=4.864,P<0.05)。干预后两组FMA-LE评分均较干预前评分显著增高,差异有统计学意义(t=5.496,t=8.353;P<0.05);观察组患者干预后FMA-LE评分显著高于对照组干预后,差异有统计学意义(t=3.995,P<0.05)。干预后,观察组患者6 MWD较干预前显著增加,10 m步行时间较干预前显著降低,差异均有统计学意义(t=9.204,t=13.422;P<0.05)。观察组干预后6 MWD明显高于对照组干预后,10 m步行时间明显短于对照组干预后,差异均有统计学意义(t=13.924,t=11.053;P<0.05)。结论:机器人辅助步态训练可增加脑部健侧FA值,促进大脑功能的重组,且对瘫痪侧下肢运动功能有显著改善作用。Objective:To investigate the effects of robot-assisted gait training on the reorganization of brain function and the functions of lower limbs after stroke.Methods:A total of 80 patients who underwent rehabilitation treatment after stroke in hospital were selected and they were divided into the observation group and the control group according to the random number table method,with 40 cases in each group.The control group received routine rehabilitation training,while the observation group received robot-assisted gait training on the basis of routine rehabilitation.Diffusion tensor imaging(DTI)was adopted to assess the fractional anisotropy(FA)values of brain before and after intervention,and the Fugl-Meyer assessment-lower extremities(FMA-LE)score,the walking distance within 6-minutes and the walking time of 10-meters were adopted to assess the statuses of the functional recoveries of the lower limbs.The changes of the above parameters before and after the intervention were compared between the two groups.Results:The FA value on the healthy side of the observation group after intervention was significantly higher than that before intervention,with statistical significance(t=5.330,P<0.05),and the FA value on the healthy side after intervention of the observation group was significantly higher than that of the control group(t=4.864,P<0.05).The FMA-LE scores of the two groups after intervention were significantly higher than those before intervention,and the differences of them were significant(t=5.496,t=8.353,P<0.05),respectively.The FMA-LE score after intervention of the observation group was significantly higher than that of the control group,and the difference was significant(t=3.995,P<0.05).Compared with before intervention,the walking distance within 6 minutes of the observation group after intervention was significantly increased,and the walking time of 10-meters of that was significant decreased,and the differences of them between before and after intervention were significant(t=9.204,t=13.422,P<0.05),respec

关 键 词：步态训练 卒中 脑功能重组 下肢功能 

分 类 号：R496[医药卫生—康复医学]