外骨骼机器人分离运动训练对脑卒中偏瘫患者下肢功能康复的效果研究  

Effect of exoskeleton robot-assisted training on lower limb functional rehabilitation in stroke patients with hemiplegia

作　　者：胥怀宇 刘丽丽[2] 任志平[3] XU Huaiyu;LIU Lili;REN Zhiping(Electromyogram Room,Daqing Oilfield General Hospital,Daqing 163011,China;Neurology,Daqing People’s Hospital,Daqing 163011,China;Neurological Intensive Care Unit,The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]大庆油田总医院肌电室,黑龙江大庆163011 [2]大庆市人民医院神经内科,黑龙江大庆163011 [3]郑州大学第一附属医院神经重症科,河南郑州450052

出　　处：《机器人外科学杂志(中英文)》2025年第3期404-409,共6页Chinese Journal of Robotic Surgery

基　　金：大庆市科技计划项目(zdv-2023-98)。

摘　　要：目的:探讨外骨骼机器人分离运动训练对脑卒中偏瘫患者下肢功能康复的影响。方法:选取2022年12月—2024年6月大庆油田总医院收治的脑卒中偏瘫患者180例作为研究对象,按照随机数字表法将其分为观察组和对照组,每组90例。对照组予外骨骼机器人随意运动轨迹(复合运动)训练,观察组予外骨骼机器人固定轨迹(分离运动)训练。比较两组训练前后6 min步行试验(6 MWT)、10 m步行测试(10 MWT)、Holden步行功能分级量表(FAC)评分、Fugl-Meyer下肢运动评定量表(FMA-LE)评分、改良Ashworth分级(MAS)评分、膝关节与髋关节活动度、改良Barthel指数(MBI)评分和体感诱发电位(SEP)。结果:与训练前相比,训练后两组患者6 MWT、10 MWT结果均提升,且观察组优于对照组(P<0.05);与训练前相比,训练后两组患者FAC与FMA-LE评分提高,MAS评分降低,与对照组相比,训练后观察组FAC与FMA-LE评分更高,MAS评分更低(P<0.05);与训练前相比,训练后两组患者膝关节和髋关节活动度提高,且观察组高于对照组(P<0.05);与训练前相比,训练后两组患者MBI各项指标评分及总分均提高,对比对照组,训练后观察组上楼、转移、步行、如厕评分及MBI总分更高(P<0.05);与训练前相比,训练后两组患者P40波幅提高,P40潜伏期缩短,与对照组相比,训练后观察组P40波幅更高,P40潜伏期更短(P<0.05)。结论:基于外骨骼机器人分离运动训练可有效改善脑卒中偏瘫患者肌张力、下肢运动功能和步行能力,提高膝关节、髋关节活动度,改善生活质量;SEP作为一项良好的康复疗效评价指标,可准确、客观反映神经功能变化情况。Objective:To explore the effect of exoskeleton robot-assisted training on lower limb functional rehabilitation in stroke patients with hemiplegia.Methods:180 patients with hemiplegia after stroke who were treated in Daqing Oilfield General Hospital from December 2022 to June 2024 were selected.They were divided into the observation group(n=90)and the control group(n=90)using the random number table method.The control group was given a random trajectory exoskeleton robotic training(compound motion),and the observation group was given a fixed trajectory exoskeleton robotic training(separated motion).The differences in the 6 min walking test(6 MWT),10 m walking test(10 MWT),Holden Walking Functional Classification Scale(FAC)scores,Fugl-Meyer Assessment of Lower Extremity(FMA-LE)scores,Modified Ashworth Scale(MAS)scores,knee and hip joint mobility,Modified Barthel Index(MBI)score,and somatosensory evoked potentials(SEP)between the two groups of patients before and after training were compared.Results:Compared with that before training,the 6 MWT and 10 MWT were improved in both groups after training,and they were better in the observation group than those in the control group(P<0.05).The FAC and FMA-LE scores were improved,and the MAS scores were reduced in both groups after training,the FAC and FMA-LE scores were higher and the MAS scores were lower in the observation group than those in the control group(P<0.05).Compared with that before training,the knee and hip mobility increased in both groups after training,and it was better in the observation group than the control group(P<0.05).The MBI scores of all indicators and total scores increased in the two groups after training,and the observation group had higher scores of going up the stairs,transferring,walking,toileting,and the total score of MBI after training compared with the control group(P<0.05).Compared with that before training,the P40 wave amplitude increased and P40 latency shortened in both groups after training,and the P40 wave amplitude was higher and P

关 键 词：下肢外骨骼机器人 分离运动 脑卒中 步行能力 体感诱发电位 

分 类 号：R493[医药卫生—康复医学]