下肢康复机器人训练对急性脑卒中患者下肢运动功能的影响

Robot-assisted lower limb rehabilitation of hemiplegia

目的探讨下肢康复机器人训练对急性脑卒中患者下肢运动功能的影响。方法将42例急性脑卒中患者按随机数字表法分为治疗组和对照组，每组21例，对照组给予常规康复治疗，治疗组在此基础上辅以下肢康复机器人训练，每次10～20min，每周6次，共8周。分别于治疗前和治疗8周后（治疗后）采用简化Fugl—Meyer运动功能量表（FMA）评定下肢运动功能，采用Berg平衡量表（BBS）评定平衡功能，采用Rivermead运动指数（RMI）评定日常生活活动（ADL）能力，以及采用功能性步行分级（FAC）评定患者步行能力，并进行统计学比较分析。结果治疗前2组患者FMA、BBS和RMI评分的组间比较，差异均无统计学意义（P〉0．05）；治疗后2组患者FMA、BBS和RMI评分均优于组内治疗前水平（P〈0．05），且治疗组均明显优于对照组（P〈0．05）。治疗前，对照组和治疗组患者能独立步行（FAC分级≥3级）的患者分别为5例（23．8％）和8例（38．1％），组间差异无统计学意义（P〉0．05）；治疗后，对照组和治疗组独立步行患者分别增加到12例（57．1％）和18例（85．7％），经统计学分析比较，治疗后2组患者步行功能均较组内治疗前有明显提高（P〈0．05），且治疗后治疗组患者步行功能明显优于同期对照组（P〈0．05）。结论下肢康复机器人训练可进一步改善急性脑卒中偏瘫患者的下肢运动功能。

Objective To investigate the effects of robot-assisted lower limb rehabilitation on the lower limb motor function of hemiplegic patients in the acute stage. Methods Forty-two hemiplegic patients in the acute stage were randomly divided into a treatment group and a control group with 21 in each. Both groups were treated with routine rehabilitation interventions, but the treatment group also undertook robot-assisted lower limb rehabilitation training. The training lasted for 10 to 20 rain/d, 6 d/week for 8 weeks. Lower limb motor function, balance, ability in the activities of daily living and walking ability were assessed with a simplified Fugl-Meyer assessment, the Berg balance scale, the Rivermead motility index （RMI） and functional ambulation categories （FACs）. Results Before the intervention there was no significant difference between the two groups in any of the assessments. After training, both groups showed significant improvements in terms of their FMA, BBS, RMI and FAC results. The treatment group showed significantly better improvements in lower limb motor function, balance, ability in daily living and walking ability compared with the control group. Conclusions Robot-assisted lower limb rehabilitation can significantly improve the lower limb motor function of hemiplegic patients in the acute stage.