下肢康复机器人配合肌电生物反馈治疗对脑卒中偏瘫患者下肢运动功能的影响

Effect of lower limb rehabilitation robot combined with electromyographic biofeedback therapy on lower limb motor function in stroke patients with hemiplegia

目的观察脑卒中偏瘫患者开展下肢康复机器人联合肌电生物反馈治疗对下肢运动功能的影响。方法选择浙江省丽水市第二人民医院康复科2016年11月~2018年11月收治的83例脑卒中偏瘫患者为研究对象,根据EpiInfo 2000版将患者分为对照组41例与观察组42例。对照组采用下肢康复机器人进行康复锻炼,观察组在对照组基础上加行肌电生物反馈治疗,两组患者均进行为期12周治疗,疗程结束后对比简式Fugl-Meyer下肢运动功能评分量表(Fugl-Meyer assessment of lower extremity,FMA-LE)、功能性步行量表(Functional ambulation category scale,FAC)、10 m步行最大速度及改良Ashworth痉挛评定量表评分。结果FMA-LE情况及10 m步行最大速度:治疗前,两组患者FMA-LE评分比较差异无统计学意义(P>0.05),治疗后观察组FMA-LE评分明显优于对照组(P<0.05);治疗后观察组10 m步行最大速度明显高于对照组(P<0.05)。FAC情况:治疗前,两组患者FAC分级比较差异无统计学意义(P>0.05),治疗后观察组FAC分级明显优于对照组(P<0.05)。改良Ashworth痉挛评定情况:治疗前,两组患者改良Ashworth痉挛评级比较差异无统计学意义(P>0.05),治疗后观察组评级明显优于对照组(P<0.05)。结论对脑卒中偏瘫患者开展下肢康复机器人配合肌电生物反馈治疗更有助于改善患者下肢运动功能与痉挛程度,操作简单,临床值得应用与推广。

Objective To observe the effect of lower limb rehabilitation robot combined with electromyographic biofeedback therapy on lower limb motor function in stroke patients with hemiplegia.Methods 83 stroke patients with hemiplegia who were admitted to the Department of Rehabilitation in the Second People's Hospital of Lishui in Zhejiang Province from November 2016 to November 2018 were selected as the study subjects.According to EpiInfo 2000,the patients were divided into 41 patients in the control group and 42 patients in the observation group.The control group was given a lower limb rehabilitation robot for rehabilitation exercises.The observation group was further given electromyographic biofeedback therapy on the basis of the control group.Both groups of patients were given treatment for 12 weeks.After the end of the treatment,the Fugl-Meyer assessment of lower extremity(FMA-LE),the Functional Ambition Category scale(FAC),the maximum speed of 10 m walking and modified Ashworth spasm rating scale scores were compared.Results FMA-LE and maximum speed of 10 m walk:there was no statistically significant difference in FMA-LE score between the two groups before treatment(P>0.05).After treatment,the FMA-LE score in the observation group was significantly better than that in the control group(P<0.05);after treatment,the maximum speed of 10 m walking in the observation group was significantly higher than that in the control group(P<0.05).FAC:there was no statistically significant difference in FAC grading between the two groups before treatment(P>0.05).After treatment,the FAC grading in the observation group was significantly better than that in the control group(P<0.05).Modified Ashworth spasm rating:there was no statistically significant difference in the modified Ashworth spasm rating score between the two groups before treatment(P>0.05).The rating in the observation group was significantly better than that in the control group after treatment(P<0.05).Conclusion The lower limb rehabilitation robot combined with electromyographic biofeedback therapy for stroke patients with hemiplegia is more helpful to improve the lower limb motor function and spasm degree.It is easy to operate and clinically worthy of application and promotion.