穿戴式外骨骼康复机器人结合Bobath技术对脑卒中偏瘫患者的影响

Effects of wearable exoskeleton rehabilitation robot combined with both technology on gait,balance ability and FMA score of lower limb movement in hemiplegic patients with stroke

目的探讨穿戴式外骨骼康复机器人结合Bobath技术对脑卒中偏瘫患者步态、平衡能力、下肢运动Fugl-Meyer功能量表(FMA)评分的影响。方法纳入2020年11月—2022年11月我院收治的78例脑卒中偏瘫患者,按照数字列表法随机分为观察组与对照组,每组39例,对照组予以Bobath技术训练,观察组在对照组基础上予以穿戴式外骨骼康复机器人训练,干预8周。比较两组干预前后的步态参数(步频、步速、跨步长比率)、平衡能力[Berg平衡量表(BBS)]、下肢运动功能FMA评分、日常生活活动能力[改良Barthel指数(MBI)]、下肢肌力恢复情况(屈髋肌力、伸膝肌力)。结果干预前,两组各指标差异无统计学意义(P>0.05);干预后,两组步频、步速、跨步长比率、BBS评分、下肢FMA评分、MBI评分、屈髋肌力、伸膝肌力较干预前显著升高(均P<0.05),观察组步频、步速、跨步长比率、BBS评分、下肢FMA评分、MBI评分、屈髋肌力、伸膝肌力高于对照组(均P<0.05)。结论穿戴式外骨骼康复机器人结合Bobath技术可改善脑卒中偏瘫患者步态和平衡能力,促进下肢运动功能恢复,提高日常生活活动能力,增强患者下肢肌力。

Objective To study the effect of wearable exoskeleton rehabilitation robot combined with Bobath technology on gait,balance ability and FMA score of lower limb movement in hemiplegic patients with stroke.Methods 78 patients with stroke hemiplegia admitted to our hospital from November 2020 to November 22 were randomly divided into the observation group and the control group according to the digital list method,with 39 patients in each group.The control group was given Bobath technical training,and the observation group was given wearable exoskeleton rehabilitation robot training on the basis of the control group,with 8 weeks of intervention.The gait parameters(gait frequency,pace,stride length ratio),balance ability[Berg balance scale(BBS)],lower limb motor function[simplified Fugl-Meyer function scale(FMA)],activity of daily living(modified Barthel index(MBI)],and lower limb muscle strength recovery(hip flexion and knee extension)were compared before and after the intervention.Results Before intervention,there was no significant difference between the two groups(P>0.05).After intervention,the step frequency,step speed,stride length ratio,BBS score,lower limb FMA score,MBI score,hip flexor strength,knee extensor strength of the two groups were significantly higher than those before intervention(P<0.05).The step frequency,step speed,stride length ratio,BBS score,lower limb FMA score,MBI score,hip flexor strength,knee extensor strength of the observation group were higher than those of the control group(P<0.05).Conclusion Wearable exoskeleton rehabilitation robot combined with Bobath technology can improve the gait and balance ability of stroke hemiplegic patients,promote the recovery of lower limb motor function,improve the ability of activities of daily living,and enhance the lower limb muscle strength of patients.