机器人辅助步态训练结合重复经颅磁刺激对创伤性不完全性脊髓损伤患者下肢功能影响的综合分析  

Comprehensive analysis of the effect of robot-assisted gait training combined with repetitive transcranial magnetic stimulation on lower limb function in patients with traumatic incomplete spinal cord injury

作　　者：曲新军 茅丽丹 陈晓丹 QU Xin-jun;MAO Li-dan;CHEN Xiao-dan(Bone and joint rehabilitation department,The Navy Qingdao Special Service Rehabilitation Center,Qingdao,Shandong 266000,China)

机构地区：[1]海军青岛特勤疗养中心骨关节康复科,山东青岛266000

出　　处：《颈腰痛杂志》2024年第4期678-682,共5页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的探讨机器人辅助步态训练结合重复经颅磁刺激(rTMS)对创伤性不完全性脊髓损伤(ISCI)患者下肢功能的影响。方法选择2020年1月至2023年10月在该院就诊的腰椎创伤性ISCI患者46例作为研究对象,采用随机数字表法将患者分为对照组和观察组各23例。对照组采用机器人辅助步态训练,观察组在对照组的基础上给予rTMS治疗。观察并比较两组患者下肢运动评分(lower extremity functional scale,LEFS)、10 m步行测试、SCI-Ⅱ步行指数(WISCI-Ⅱ)、改良Ashworth量表(MAS)、步态测量的改善情况。结果治疗后,两组患者LEFS评分均较治疗前显著升高(P<0.05),且观察组患者治疗后LEFS评分显著高于对照组(P<0.05)。治疗后,两组患者10 m步行试验时间较治疗前显著降低,WISCI-Ⅱ较治疗前显著升高,差异均有统计学意义(P<0.05);治疗后,两组患者10 m步行试验和WISCI-Ⅱ相比较,差异无统计学意义(P>0.05)。治疗后,两组患者膝伸肌、髋内收肌、踝跖屈肌MAS与治疗前差异无统计学意义(P>0.05);治疗后两组患者上述指标差异无统计学意义(P>0.05)。治疗后,两组患者步速均较治疗前显著升高(P<0.05),但两组患者治疗后步速差异均无统计学意义(P>0.05);治疗前,两组患者步频、单支撑时间、双支撑时间、步长等差异均无统计学意义(P>0.05),且治疗后两组患者步频、单支撑时间、双支撑时间、步长等差异均无统计学意义(P>0.05)。结论rTMS可改善慢性创伤性ISCI患者的下肢运动功能,但对步态特征、支撑依赖程度和痉挛水平的影响不显著。Objective To investigate the effect of robot-assisted gait training combined with repetitive transcranial magnetic stimulation(rTMS)on lower limb function in patients with traumatic incomplete spinal cord injury(ISCI).Method Forty-six patients with traumatic ISCI in our hospital from January 2020 to October 2023 were selected as the study objects.The patients were randomly divided into a control group and an observation group using a random number table method,with 23 cases in each group.The improvement of lower extremity functional scale(LEFS),10-meter walking test,SCI-Ⅱwalking index(WISCI-Ⅱ),modified Ashworth scale(MAS)and gait measurement were observed and compared between the two groups.Results After treatment,the LEFS of both groups of patients significantly increased compared to before treatment(P<0.05),and the LEFS of the observation group was significantly higher than that of the control group after treatment(P<0.05).After treatment,the 10 meter walking test of the two groups significantly decreased compared to before treatment,and the WISCI significantly increased compared to before treatment,with statistical significance(P<0.05).There was no statistically significant difference between the 10 meter walk test and WISCI between the two groups after treatment(P>0.05).After treatment,there was no statistically significant difference in the MAS of knee extensor muscle,hip adductor muscle,and ankle plantar flexor muscle between the two groups compared to before treatment(P>0.05),and there was no statistically significant difference in the above indicators between the two groups after treatment(P>0.05).After treatment,the walking speed of both groups significantly increased compared to before treatment(P<0.05),but there was no statistically significant difference in walking speed between the two groups after treatment(P>0.05).There was no statistically significant difference in step frequency,single support time,double support time,and step length between the two groups before and after treatment(P>0.05),a

关 键 词：脊髓损伤 步态训练 机器人 重复经颅磁刺激 

分 类 号：R683.2[医药卫生—骨科学]