康复机器人结合动作观察疗法对脑卒中患者上肢运动功能康复的影响

Effect of rehabilitation robot combined with action observation therapy on rehabilitation of upper limb motor function in stroke patients

目的观察康复机器人结合动作观察疗法对脑卒中患者上肢运动功能康复的作用。方法选择2022年4-12月在联勤保障部队大连康复疗养中心就诊的初发脑卒中患者46例(病程<3个月)。利用随机数字表法将入选患者分为对照组及试验组,每组23人。两组均接受常规康复治疗及上肢康复机器人训练。上肢康复机器人训练前,试验组采用动作观察疗法观看与上肢有关的日常生活动作和活动视频,之后患者想象自己利用患侧上肢完成这些动作;对照组观看英文字母、汉字、几何图形或没有动物及人的视频。治疗前、治疗4周,采用简式Fugl-Meyer运动功能评分-上肢部分(FMA-UE)、运动评定量表上肢部分(MAS-UE)、改良Barthel指数(MBI)对两组患者进行上肢功能评定。结果治疗前,两组患者FMA-UE、MAS-UE、MBI评分均无统计学差异(P>0.05);治疗后,两组FMA-UE、MAS-UE、MBI均显著提高(P<0.001);治疗后,试验组FMA-UE(P=0.039)、MAS-UE(P=0.027)、MBI(P=0.004)高于对照组,差异具有统计学意义。结论康复机器人结合动作观察疗法,能够进一步改善脑卒中患者的上肢运功功能,提高日常生活活动能力。

Objective To explore the effect of rehabilitation robot combined with action observation therapy on the rehabilita-tion of upper limb motor function in patients with stroke.Methods A total of 46 patients with initial stroke(disease course<3 months)selected from Dalian Rehabilitation and Recuperation Center from April to December 2022 were randomly divided into control group(n=23)and observation group(n=23).Both groups received routine rehabilitation treatment and upper limb robot-assisted therapy.Before the training of robot-assisted therapy,the observation group watched the videos about activities and movements of upper limb,and then were asked to imagine their affected upper limb to complete these activities and movements.The control group watched the videos of geometric figures,letters and others without body or animals.Before treatment and 4 weeks after treatment,they were evaluated with simplified Fugl-Meyer Assessment-Upper Extremities(FMA-UE),Motor Assessment Scale-Upper Extremities(MAS-UE)and modified Barthel Index(MBI).Results Before treatment,there were no significant differences in FMA-UE,MAS-UE and MBI scores between the two groups(P>0.05).After treatment,FMA-UE,MAS-UE and MBI significantly increased in both groups(P<0.001).After treatment,FMA-UE(P=0.039),MAS-UE(P=0.027)and MBI(P=0.004)in the observation group were higher than those in the control group,and the differences were statistically significant.Conclusions Rehabilitation robot combined with action observation therapy can further improve the upper limb motor function and the ability of daily living of stroke patients.