康复机器人训练对脑卒中患者偏瘫上肢运动功能恢复的疗效评估

Evaluation to Efficiency of Robot-Assisted Rehabilitation Training for Recovery of Upper Limb＇s Motor Function of Patients with Hemiplegia after Stroke

目的：观察康复机器人对脑卒中偏瘫患者上肢运动功能的恢复效果及对上肢神经传导速度的影响。方法：将60例患者随机分为对照组（30例）和试验组（30例），对照组给予常规肢体功能训练，包括运动疗法（PT）和作业治疗（0T）；试验组除常规肢体功能训练外，还进行上肢康复机器人训练。两组患者每项训练各进行30min，每天1次，每周5次，4周为一个疗程，两组患者均在训练前、训练后2周及训练后4周时分别进行手握力评定、改良Ashworth评分（MAs）、上肢神经传导速度及运动力指数（MI）评估偏瘫患者的上肢功能。结果：训练前，两组患者手握力、改良Ashworth评定（MAS）、上肢神经传导速度及运动力指数（MI）评分差异无统计学意义（P〉0．05）。训练4周后，两组患者的手握力及MI评分均较训练前显著改善（P=0．01），试验组优于对照组（P〈0．01）；试验组上肢神经传导速度和肘、腕屈肌MAS较训练前有均有显著好转（P〈0．01），对照组较训练前亦有改善（P〈0．05），试验组上肢神经传导速度相比对照组有显著改善（P〈0．01），试验组肘、腕屈肌MAS较对照组亦有改善（P〈0．05）。结论：康复机器人结合常规肢体功能训练能更有效地促进脑卒中偏瘫患者上肢功能的恢复，并有效降低肌痉挛及改善上肢神经传导速度。

Objective： To observe the recovery efficiency of rehabilitation robots on the upper limb＇s motor function and the influence on upper limb＇s nerve conduction velocity of patients with hemiplegia after stroke. Methods： 60 cases of patients were randomly divided into control group （30 cases） and experimental group （30 cases）, the control group treated by conventional limb＇s function training, including PT and OT; except conventional function training, the experimental group also treated by robot-assisted rehabilitation training to upper limb. Two groups of patients were both trained for 30min in each training, 1 time per day, 5 times per week and 4 Weeks as a course of treatment, and finally evaluated the hand grip, MAS scores, up- per limb＇s nerve conduction velocity and MI scores to assess patients＇ upper limb＇s function at the time of before training, 2 weeks and 4 weeks after training. Results： Before training, the hand grip, MAS scores, upper limb＇s nerve conduction velocity and MI scores of two groups had no statistical difference （P〉0.05）. 4 weeks after trainirig, the hand grip and MI scores were improved （P〈0.05）, and that of experimental group was better than con- trol group （P〈0.01）; the upper limb＇s never conduction velocity and elbow and wrist flexors were all turned better （P〈0.01）, those of control group were also improved （P〈0.05）, but the upper limb＇s never conduction velocity of experimental group was significantly better than control group （P〈 0.01） and the elbow and wrist flexors of experimental group were also much improved than control group （P〈0.05）. Conclusion： Rehabilitation ro- bots combined with conventional limb＇s function training can much effectively improve the recovery of upper limb＇s function of patients with hemiplegia after stroke, and effectively decrease myospasm and improve upper limb＇s never conduction velocity.