外骨骼机器人对脑卒中患者平衡和下肢功能的影响Meta分析  

Effects of Exoskeleton Robots on Balance and Lower Limb Function of Patients with Stroke:A Meta-Analysis

作　　者：彭小柯 赵国顺 韩诗雨 董安琴 PENG Xiaoke;ZHAO Guoshun;HAN Shiyu;DONG Anqin(The Fifth Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan 450052,China)

机构地区：[1]郑州大学第五附属医院,河南郑州450052

出　　处：《康复学报》2025年第2期197-204,共8页Rehabilitation Medicine

基　　金：国家重点研发计划项目(2022YFC3601700);河南省高等学校重点科研项目(24A320018)。

摘　　要：目的运用Meta分析方法探讨外骨骼机器人对脑卒中患者平衡和下肢功能的影响。方法计算机检索中国科技期刊全文数据库(CNKI)、万方数据库(Wanfang Data)、维普中文科技期刊数据库(VIP)、PubMed、Cochrane Library、EMbase、Web of Science数据库有关外骨骼机器人训练改善脑卒中患者下肢功能及平衡能力的随机临床对照试验(RCTs),检索时限均为建库至2024年6月。主要结局指标包括平衡功能(BBS)评分和下肢运动功能(FMA-LE)评分。数据提取和文献质量评价由2名研究者独立进行,采用Stata 16.0软件进行Meta分析。连续性变量采用加权均数差(WMD)表示,并计算其95%置信区间(CI)。结合I2定量判断异质性大小,若I2≤50%,P≥0.1,各研究不存在异质性或异质性较小,采用固定效应模型;当P<0.1,I2>50%时,各研究异质性较大,采用随机效应模型。结果共纳入9篇文献,共计467例患者。Meta分析结果显示,与对照组比较,试验组治疗后BBS评分明显提高[WMD=2.24,95%CI(0.57,3.91),Z=2.63,P=0.009],FMA-LE评分明显提高[WMD=2.30,95%CI(1.39,3.21),Z=4.97,P<0.001]。BBS评分亚组分析结果显示,步态训练时长≤30 min时,试验组治疗后BBS评分明显高于对照组[WMD=2.49,95%CI(0.76,4.23),Z=2.82,P=0.005];步态训练时长>30 min,2组BBS治疗后评分差异无统计学意义[WMD=-1.04,95%CI(-7.23,5.15),Z=-0.33,P=0.743];干预周期≤4周,试验组治疗后BBS评分明显高于对照组[WMD=1.86,95%CI(0.10,3.62),Z=2.07,P=0.038];干预周期>4周,试验组治疗后BBS评分明显高于对照组[WMD=5.57,95%CI(0.31,10.82),Z=2.08,P=0.038]。FMA-LE评分亚组分析结果显示,步态训练时长≤30 min,试验组治疗后FMA-LE评分明显高于对照组[WMD=2.29,95%CI(1.35,2.23),Z=4.78,P<0.001];步态训练时长>30 min,2组治疗后FMA-LE评分差异无统计学意义[WMD=2.45,95%CI(-1.04,5.94),Z=1.38,P=0.169];干预周期≤4周,试验组治疗后FMA-LE评分明显高于对照组[WMD=1.96,95%CI(0.71,3.22),Z=2.43,P=0.002]Objective To evaluate the effects of exoskeleton robot training on balance and lower limb function of patients with stroke by meta-analysis.Methods Data were searched and retrieved from the database of China National Knowledge Infrastructure(CNKI),Wanfang Data,Chinese Science and Technology Periodical Database(VIP),PubMed,Cochrane Library,EMbase,and Web of Science.The randomized controlled trials(RCTs)of exoskeleton robots training on balance and lower limb function of patients with stroke were included,and the retrieval time was from the database inception to June 2024.The primary outcome indicators included Berg Balance Scale(BBS)score and Fugl-Meyer Assessment of Lower Extremity(FMA-UE)score.Data extraction and literature quality assessment were independently conducted by two researchers,and the meta-analysis was performed using Stata 16.0 software.Continuous variables were expressed by weighted mean difference(WMD)with 95%confidence interval(CI).The heterogeneity was determined according to the I 2 value.If I 2≤50%and P≥0.1,indicating low or no heterogeneity among the studies,a fixed-effect model would be used;if P<0.1,I 2>50%,indicating high heterogeneity,a random effect model would be used.Results A total of 9 RCTs were included,involving 467 patients.The meta-analysis results showed that,compared with the control group,BBS score in the experimental group after treatment was significantly higher[WMD=2.24,95%CI(0.57,3.91),Z=2.63,P=0.009]and FMA-LE score was significantly higher[WMD=2.30,95%CI=(1.39,3.21),Z=4.97,P<0.001].Subgroup meta-analysis of BBS scores showed that,when gait training lasted≤30 minutes,BBS score in the experimental group after treatment was significantly higher than the control group[WMD=2.49,95%CI(0.76,4.23),Z=2.82,P=0.005];when gait training duration was>30 minutes,there was no statistically significant difference in BBS scores between two groups[WMD=-1.04,95%CI=(-7.23,5.15),Z=-0.33,P=0.743];when the intervention period was≤4 weeks,BBS score in the experimental group after treatm

关 键 词：脑卒中 外骨骼机器人 平衡功能 下肢运动功能 META分析 

分 类 号：R743.3[医药卫生—神经病学与精神病学]