上肢机器人辅助疗法对急性期脑卒中患者上肢运动功能的效果

Effects of Upper Limb Robot-assisted Therapy on Motor Recovery in Patients with Acute Stroke

目的探讨上肢机器人辅助疗法对急性期偏瘫患者上肢运动功能的效果。方法 2013年8月~2014年9月,46例急性期脑卒中患者随机分为实验组和对照组各23例。两组均进行常规康复训练,实验组增加上肢机器人辅助疗法训练,对照组增加上肢重复性运动训练,30 min/d,5 d/周,共12周。治疗前后分别采用Fugl-Meyer上肢部分（FM-UL）评定上肢及手部的运动功能,改良Ashworth量表（MAS）评定肘关节肌张力,改良Barthel指数（MBI）评定日常生活活动能力。结果治疗后,两组患者FM-UL评分、MAS分级、MBI均较治疗前改善（t〉3.856,Z〉1.889,P〈0.05）,且实验组FM-UL评分、MAS分级优于对照组（t=-2.386,Z=-2.625,P〈0.05）,实验组MBI与对照组比较无显著性差异（t=-1.326,P=0.098）。结论上肢机器人辅助疗法可促进急性期脑卒中患者上肢运动功能恢复。

Objective To explore the effects of upper limb robot-assisted therapy on motor recovery in acute stroke patients. Methods From August, 2013 to September, 2014, 46 acute stroke patients at their first-ever stroke were enrolled and randomized into experimental group and control group with 23 cases in each group. Both groups received routine therapy. Additional robot-assisted therapy was provided to the experimental group, and additional repetitive movement training was provided to the control group, 30 minutes a day, 5 days a week for 12 weeks. Fugl-Meyer Assessment-Upper Limb （FM-UL）, modified Ashworth Scale （MAS） and modified Barthel index （MBI） were used to assess the motor function of the upper limbs and hands, the muscular tension of elbow, and activities of daily living （ADL） before and after treatment. Results After treatment, the scores of FM-UA, MAS and MBI improved in both groups （t〉3.856, Z〉1,889, P〈0,05）, and the scores of FM-UA and MAS were better in the experiment group than in the control group （t=-2.386, Z= 2.625, P〈0.05）, however, there was no significant difference in the score of MBI between two groups （t=- 1.326, P=0.098）. Conclusion Upper limb robot-assisted therapy can facilitate the recovery of the motor function of upper limbs in acute stroke patient.