康复机器人辅助训练在脑卒中后上肢功能障碍患者中的应用分析  

Application analysis of rehabilitation robot-assisted training in patients with upper limb dysfunction after stroke

作　　者：王凤双 杨杰 杨帆 WANG Fengshuang;YANG Jie;YANG Fan(Rehabilitation diagnosis and treatment center,Beijing Rehabilitation Hospital of Capital Medical University,Beijing 100144,China)

机构地区：[1]首都医科大学附属北京康复医院康复诊疗中心,北京100144

出　　处：《机器人外科学杂志(中英文)》2025年第2期260-265,共6页Chinese Journal of Robotic Surgery

基　　金：国家重点研发计划(2020YFC2004303)。

摘　　要：目的:探讨康复机器人辅助训练对脑卒中后上肢功能障碍患者康复的影响。方法:选取2021年12月-2023年12月于首都医科大学附属北京康复医院收治的90例脑卒中后上肢功能障碍患者,按随机数字表法分为对照组(45例,采用任务导向训练)和观察组(45例,采用任务导向训练联合康复机器人辅助训练),对比两组患者上肢功能、手功能、患肢关节活动度、患肢表面肌电图及脑功能连接情况。结果:观察组训练后的Fugl-Meyer运动量表(FMA)评分高于对照组,Jebsen Taylor手功能测试(JTT)时间短于对照组,腕关节的掌屈、背伸、尺偏及桡偏的活动度高于对照组(P<0.05)。观察组训练后屈肘、伸肘时的肌电图值高于对照组,患侧初级运动皮质区(M1)、前运动皮质区(PMC)、辅助运动区(SMA)的HbO2浓度高于对照组(P<0.05)。结论:对脑卒中后上肢功能障碍患者应用康复机器人辅助训练联合任务导向训练,利于患者上肢功能、手功能的康复,增加关节活动度,促进脑功能重组,值得临床应用。Objective:To explore the effect of rehabilitation robot-assisted training on rehabilitation of patients with upper limb dysfunction after stroke.Methods:90 patients with upper limb dysfunction after stroke who were treated in Beijing Rehabilitation Hospital of Capital Medical University from December 2021 to December 2023 were selected and divided into the control group(task-oriented training,n=45)and the observation group(task-oriented training combined with rehabilitation robot-assisted training,n=45)using the random number table method.The upper limb and hand function,motion range of affected limb joint,affected limb surface electromyography,and brain functional connectivity status were compared between the two groups of patients.Results:In the observation group,the Fugl-Meyer Motor Scale(FMA)scores after training,the mobility of palmar flexion,dorsiflexion,ulnar deviation,and radial deviation of the wrist joint,the electromyographic values during elbow flexion and extension,and the concentration of hemoglobin oxytocopherol(HbO2)in the primary motor cortical area(M1),premotor cortical area(PMC),and supplementary motor area(SMA)of the affected side were higher than those of the control group(P<0.05),and the Jebsen Taylor hand function test(JTT)time was shorter than the control group(P<0.05).Conclusion:Rehabilitation robot-assisted training combined with task-oriented training can promote the rehabilitation of upper limb and hand function,enhance joint mobility,and improve the reorganization of brain function in patients with upper limb dysfunction after stroke,which is worth applying.

关 键 词：康复机器人 任务导向训练 脑卒中 上肢功能障碍 

分 类 号：R743.3[医药卫生—神经病学与精神病学]