文章摘要
陈芳,季晶,苏彬,等.平地行走式下肢外骨骼机器人对脑卒中患者步行功能的影响[J].中华物理医学与康复杂志,2022,44(6):497-502
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平地行走式下肢外骨骼机器人对脑卒中患者步行功能的影响
  
DOI:10.3760/cma.j.issn.0254-1424.2022.06.004
中文关键词: 下肢外骨骼机器人; 脑卒中; 步行训练; 下肢运动功能  康复
英文关键词: Robots  Exoskeletal robots  Stroke  Gait training  Lower limb motor function  Rehabilitation
基金项目:南京市科学技术局(2019060002);无锡 “太湖人才计划”医疗卫生高层次人才项目(WXTTP2020008);江苏省研究生科研与实践创新计划(KYCX21_1976)
作者单位
陈芳 南京体育学院南京 210014 
季晶 南京医科大学第一附属医院南京 210029 
苏彬 无锡市同仁康复医院无锡 214150 
邱怀德 南京医科大学第一附属医院南京 210029 
吴希希 江苏省人民医院钟山康复分院南京 210046 
黄颖珺 江苏省人民医院钟山康复分院南京 210046 
黄思思 南京医科大学第一附属医院南京 210029 
张宇婷 南京医科大学第一附属医院南京 210029 
王雪 南京医科大学第一附属医院南京 210029 
万春利 南京医科大学第一附属医院南京 210029 
葛盼丽 南京医科大学第一附属医院南京 210029 
黄俊豪 南京体育学院南京 210014 
李勇强 南京体育学院南京 210014
南京医科大学第一附属医院南京 210029 
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中文摘要:
      目的 观察平地行走式下肢外骨骼机器人训练对脑卒中患者步行功能的疗效。 方法 按随机数字表法将58例脑卒中患者分为机器人组(29例)和对照组(29例)。对照组给予常规康复治疗联合常规步行训练,机器人组则给予常规康复治疗联合外骨骼机器人步行训练。2组患者的步行训练均为每日2次,每次30 min,每周训练5 d,连续每次4周。于治疗前、治疗2周和4周后对2组患者的步行能力[包括6 min步行测试(6MWT) 和功能性步行分级(FAC)]和下肢运动功能[Fugl-Meyer下肢运动评定量表(FMA-LE)]进行评估,并于治疗前和治疗4周后检测2组患者的步态。 结果 治疗2周和4周后,2组患者的6MWT较组内治疗前均明显提高,差异均有统计学意义(P<0.01)。机器人组治疗2周后与组内治疗前的6MWT差值与对照组比较,差异有统计学意义(P=0.034)。治疗2周和4周后,2组患者的FMA-LE和FAC较组内治疗前均显著改善,差异均有统计学意义(P<0.01)。治疗4周后,2组患者的步频和步态周期与组内治疗前比较,差异均有统计学意义(P<0.01)。 结论 平地行走式下肢外骨骼机器人训练可改善脑卒中患者的步行能力和下肢运动功能,其疗效与常规步行训练相当。
英文摘要:
      Objective To explore the efficacy of a flat ground exoskeleton robot in improving the walking ability of stroke survivors. Methods Fifty-eight stroke survivors with mobility difficulties were randomly divided into a robot group (n=29) and a control group (n=29). In addition to routine rehabilitation, the control group received conventional walking training, while the robot group underwent exoskeleton robot-assisted gait training. The 30-minute training sessions were held twice a day, 5 days per week for 5 weeks. Before as well as after 2 and 4 weeks of treatment, everyone′s walking ability was tested using the 6-minute walk test (6MWT) and functional ambulation scale (FAC). General lower limb motor function was quantified using the Fugl-Meyer Lower Extremity assessment (FMA-LE). Moreover, gait analysis was conducted before and after 4 weeks of treatment. Results After 2 and 4 weeks of treatment, the average 6MWT times of both groups were significantly better than before the treatment, with the improvement of the robot group significantly greater than that of the control group after 2 weeks. After 2 and 4 weeks the average FMA-LE and FAC scores of both groups had improved significantly compared with before treatment. After 4 weeks the stride frequency and gait cycle of both groups had improved significantly. Conclusions Exoskeleton robot-assisted gait training can improve walking ability and lower limb motor function of stroke survivors about as well as conventional walking training.
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