上肢康复机器人训练对亚急性脑卒中患者认知和上肢运动功能的效果

Effects of upper limb robot-assisted training on cognition and upper limb motor function for subacute stroke pa‐tients

目的探讨上肢康复机器人训练对亚急性脑卒中患者认知功能、上肢运动功能和日常生活能力的影响。方法2019年9月至2020年9月,温州医科大学附属第一医院康复科亚急性期脑卒中并发认知障碍的偏瘫患者65例随机分为对照组(n=32,脱落2例)和试验组(n=33,脱落3例)。两组均接受常规作业治疗,对照组接受常规认知训练,试验组接受上肢康复机器人训练,共4周。治疗前后采用蒙特利尔认知评估(MoCA)、简易精神状态检查(MMSE)、Fugl-Meyer评定量表上肢部分(FMA-UE)和改良Barthel指数(MBI)进行评定。结果治疗后,两组MoCA、MMSE、FMA-UE和MBI评分均显著改善(t>22.11,Z>4.79,P<0.001),试验组MoCA总分及部分维度分,MMSE总分及部分维度分,FMA-UE总分及手臂分,MBI评分均优于对照组(t>2.06,Z>3.19,P<0.05)。结论上肢康复机器人训练有助于改善亚急性脑卒中患者的认知功能、上肢运动功能和日常生活活动能力。

Objective To investigate the effects of upper limb robot-assisted training on cognitive function,upper limb motor func‐tion and activity of daily living for subacute stroke patients.Methods From September,2019 to September,2020,65 subacute stroke hemiplegic patients with cognitive impairment were randomly divided into control group(n=32,two cases dropped)and experimental group(n=33,three cas‐es dropped).Both groups accepted conventional occupational therapy;and then,the control group accepted con‐ventional cognitive training,while the experimental group accepted upper limb robot-assisted training,for four weeks.They were assessed with Montreal Cognitive Assessment(MoCA),Mini-Mental State Examination(MMSE),Fugl-Meyer Assessment-Upper Extremities(FMA-UE)and modified Barthel Index(MBI)before and after treatment.Results The scores of MoCA,MMSE,FMA-UE and MBI improved after treatment in both groups(t>22.11,Z>4.79,P<0.001),the MoCA total score and some item-scores,MMSE total score and some item-scores,FMA-UE total score and the score of arm,and score of MBI improved more in the experimental group than in the control group(t>2.06,Z>3.19,P<0.05).Conclusion Upper limb robot-assisted training could facilitate to improve the cognitive function,upper limb motor func‐tion and activities of daily living in subacute stroke patients.