骨盆减重康复机器人训练对脑卒中后偏瘫患者下肢功能的影响

Effects of weight bearing robot assisted training on the lower limb function of hemiplegic patients following stroke

目的:探讨骨盆减重康复机器人对脑卒中后偏瘫患者下肢功能的影响。方法:将脑卒中偏瘫患者39例随机分为观察组19例和对照组20例。其中观察组予常规康复治疗结合骨盆减重康复机器人训练,对照组予常规康复治疗结合针对性的平衡和步行训练。在治疗前后采用Brunnstrom下肢分期、Fugl-Meyer下肢运动功能评分、Berg平衡量表、功能性步行量表(FAC)、Barthel指数进行评估。结果:治疗2周后,2组Brunnstrom下肢运动功能分期较治疗前及2组间比较差异均无统计学意义;观察组Fugl-Meyer下肢运动功能评分较治疗前明显提高(P<0.05),2组间比较差异无统计学意义,对照组Fugl-Meyer下肢运动功能评分较治疗前差异无统计学意义。治疗3周后,观察组Brunnstrom下肢运动功能分期、Fugl-Meyer下肢运动功能评分均较治疗前明显提高(P<0.05),但2组间比较差异无统计学意义,对照组Brunnstrom下肢运动功能分期、Fugl-Meyer下肢运动功能评分治疗前后比较差异无统计学意义。治疗2周后,2组Berg平衡量表评分均较治疗前明显提高(均P<0.05),2组间比较差异无统计学意义;治疗3周后,2组Berg平衡量表评分较治疗前均明显提高(均P<0.05),且观察组明显高于对照组(P<0.05)。治疗2周后,2组Barthel指数评分较治疗前均明显提高(P<0.05),2组间比较差异无统计学意义;治疗3周后,2组Barthel指数评分均较治疗前均明显提高(均P<0.05),2组间比较差异无统计学意义。结论:骨盆减重康复机器人训练可以有效改善脑卒中后偏瘫患者的平衡功能、下肢运动功能及日常生活活动能力,且在平衡功能改善方面优于康复治疗师指导下的康复训练。

Objective:To observe the effects of weight-bearing robot-assisted training on the lower limb function of hemiplegic patients after stroke.Methods:Thirty-nine stroke patients were divided into two groups by a random number method,including 19 in the robot group and 20 in the control group.The robot group received physical therapy combined with weight-bearing robot-assisted training for the lower limb.The control group received physical therapy with therapist-guiding balance and gait training.The functional outcomes were Brunnstrom scale(lower limb),Fugl-Meyer assessment(FMA),Berg balance scale,functional ambulation category scale(FAC),and Barthel index(BI)before,2 weeks and 3 weeks after the rehabilitation.Results:After 2-week rehabilitation,there was no significant change of Brunnstrom scale in both groups and no significant difference between the two groups;FMA of lower limb in robot group after 2 weeks was better than before(P<0.05)with no significant difference between two groups,while control group had no changes after 2-week rehabilitation.After 3-week rehabilitation,Brunnstrom scale and FMA of lower limb in robot group were improved significantly as compared with baselines,but there was no significant difference between two groups.There were no significant differences in Brunnstrom scale and FMA of lower limb in control group before and after 2-week rehabilitation.After 2-week rehabilitation,there was significant difference in Berg balance scale in both groups(P<0.05)with no significant difference between two groups.After 3-week rehabilitation,there was significant difference in Berg balance scale(P<0.05)in both groups,and robot group was better than control group(P<0.05).After 2-week and 3-week rehabilitation,Barthel Index was improved significantly as compared with baselines in both groups(P<0.05)with no significant difference between two groups.Conclusion:Weight-bearing robot assisted training for the lower limb can improve balance,motor function of lower limb,and activities of daily living in hemiplegic patients following stroke.The robot training is better than physical exercise instructed by therapists in balance.