上肢康复机器人对急性期脑卒中患者上肢运动功能恢复的影响

Robots for the rehabilitation of upper limb motor function after stroke

目的观察上肢康复机器人对急性期脑卒中患者上肢运动功能恢复的影响。方法选取急性期脑卒中患者100例，按照随机数字表法将其分为对照组和治疗组，每组50例。对照组给予常规康复训练和药物治疗，治疗组在对照组基础上增加上肢康复机器人训练，每日1次，每周5d，持续12周。治疗前及治疗4周、8周、12周后，采用Fugl—Meyer运动功能量表上肢部分（FMA-UE）、改良Ashworth量表（MAS）、改良Bathel指数（MBI）对2组患者的上肢运动功能和日常生活活动能力进行评定。结果与组内治疗前比较，2组患者治疗后FMA—UE评分、FMA—UE肩肘部分评分、FMA—UE腕手部分评分、MBI评分随治疗时间延长呈逐渐上升趋势（P〈0．05）。治疗组治疗4周、8周、12周后的FMA-UE评分、FMA—UE肩肘部分评分、FMA．UE腕手部分评分均显著高于对照组（P〈0．05）。与对照组治疗后同时间点比较，治疗组治疗4周[（54．66±18．61）分]、8周[（65．54±15．78）分]、12周[（74．96±15．61）分]后的MBI评分显著较高（P〈0．05）。治疗前及治疗4周、8周、12周后，2组患者肘关节、腕关节MAS评分组内及组问比较，差异均无统计学意义（P〉0．05）。结论上肢康复机器人训练可显著提高急性期脑卒中患者的上肢运动功能和日常生活活动能力，值得临床应用、推广。

Objective To observe the effect of robot-assisted upper limb training on the recovery of upper limb motor function after stroke. Methods One hundred patients within one month of suffering a stroke were ran- domly divided into a control group （50 cases） and a therapy group （50 cases）. Both groups were given convention- al drug therapy and rehabilitation training, while the therapy group also received robot-assisted training once a day, 5 days per week for 12 weeks. The Fugl-Meyer assessment for the upper extremities （FMA-UE） , the modified Ashworth scale （MAS） and the modified Barthel index （MBI） were used to evaluate the subjects before the experi- ment and after 4, 8 and 12 weeks of treatment. Results During the treatment, the average FMA-UE scores and the average MBI of both groups increased gradually. The treatment group＇s averages were significantly better than those of the control group at each time point, except that there was no significant difference in elbow and wrist MAS scores. Conclusion Upper limb robots can be used with acute stroke patients in a clinical setting, and they may be beneficial for improving upper limb function and ability in the activities of daily living.