下肢康复训练机器人对脑梗死偏瘫病人步行功能与P300影响

EFFECT OF THE LOWER LIMB REHABILITATION TRAINING ROBOT ON WALKING FUNCTION AND P300 IN PATIENTS WITH HEMIPLEGIA DUE TO CEREBRAL INFARCTION

目的探讨下肢康复训练机器人对脑梗死偏瘫病人步行功能与P300的影响。方法脑梗死偏瘫病人60例,随机分为对照组和机器人组,各30例。对照组采用常规康复疗法,机器人组在常规康复疗法的基础上给予Lokomat康复训练为主的运动训练方法。两组分别于干预前及干预8周后,采用步态分析仪检测步长、步宽、步频、步速及事件相关电位（ERP）N100、N200、P200和P300电位。结果干预前,两组病人步长、步宽、步频和步速比较差异无显著性（P〉0.05）;干预后,两组步长、步宽、步频和步速均高于干预前,机器人组高于对照组,差异有显著性（t=3.844~12.946,P〈0.05）。干预前,两组N100、N200、P200和P300潜伏期及P300波幅差异无显著性（P〉0.05）;干预后,两组N200和P300潜伏期较干预前降低,P300波幅较干预前增高;机器人组N200和P300潜伏期较对照组降低,P300波幅较对照组增高,差异有显著性（t=2.160~4.251,P〈0.05）。结论早期进行机器人康复训练可改善脑梗死病人步行功能,并且对于脑卒中病人认知功能的提高具有明显的促进作用。

Objective To investigate the effect of lower limb rehabilitation training robot on walking function and P300 in patients with hemiplegia due to cerebral infarction（CI）. Methods Sixty hemiplegic patients due to CI were equally randomized to control group and robot group.A conventional rehabilitation therapy was carried out in patients of the control group,and those in the robot group an additional Lokomat rehabilitation training was conducted on the basis of conventional rehabilitation therapy.The walking ability and the electromyography evoked potential instrument were used to measure the step length,step width,cadence and walking speed and the motor function and component of event related potent（ERP）-N100,N200,P200 and P300,before and eight weeks after therapy. Results Before training,there was no significant difference between the two groups with regard to the step length,step width,cadence and walking speed;after training,the numerical values of the above items were higher than before,and that in the robot group was higher than the control,the differences were significant（t=3.844-12.946,P〈0.05）.The differences of latency of N100,N200,and P200,and amplitude of P300 between the two groups were not significant（P〉0.05）;after intervention,the latency of N200 and P300was lower than before,and P300 elevated,the latency of N200 and P300in the robot group reduced versus the control,and P300elevated（t=2.160-4.251;P〈0.05）. Conclusion Carrying out early robot rehabilitation training can improve the walking function of patients suffering cerebral infarction,and it has a significant role in promoting patient＇s cognition.