机器人辅助步态训练联合综合康复训练对脑卒中患者步态及生活质量的影响

Effect of robot-assisted gait training combined with comprehensive rehabilitation training on gait and quality of life of stroke patients

目的探讨机器人辅助步态训练(RAGT)联合12周综合康复训练对脑卒中患者步态康复及生活质量的影响。方法选取2019-08—2021-04在首都医科大学附属北京康复医院治疗的80例脑卒中患者进行前瞻性研究,采用随机数字表法将80例患者分为观察组(n=42)和对照组(n=38)。观察组给予RAGT联合12周综合康复训练,对照组给予12周综合康复训练,采用Fugl-Meyer量表(FMA)、Berg平衡量表(BBS)评估患者下肢运动功能、平衡能力,改良Barthel指数(MBI)评价患者日常生活活动能力,生存质量评分(SS-QOL)量表评估患者生活质量,同时检查2组下肢肌肉表面肌电、10 m最快步行速度(10 m MWS)和跨步长。结果观察组干预后FMA和BBS评分分别为(29.10±2.15)分和(49.92±4.10)分,明显高于对照组(P<0.05);观察组干预后股直肌、腘绳肌、胫骨前肌和腓肠肌内侧头表面肌电图均方根值(RMS)分别为(71.19±8.81)μV、(54.49±5.72)μV、(53.15±2.80)μV和(51.12±4.42)μV,明显高于对照组(P<0.05);观察组干预后10 m MWS和跨步长分别为(42.54±3.54)m/min和(90.54±8.82)cm,明显高于对照组(P<0.05);观察组干预后MBI和SS-QOL评分分别为(89.92±6.87)分和(92.39±9.45)分,明显高于对照组(P<0.05)。结论RAGT联合12周综合康复训练能明显改善脑卒中患者步态及生活质量。

Objective To investigate the effect of robot assisted gait training(RAGT)combined with 12 week comprehensive rehabilitation training on gait rehabilitation and quality of life of stroke patients.Methods Eighty cases of stroke patients treated in the Beijing Rehabilitation Hospital Affiliated to Capital Medical Universi⁃ty from August 2019 to April 2021 were selected,80 patients were randomly divided into observation group(n=42)and control group(n=38)and the prospective research was conducted.The observation group was given RAGT combined with 12 weeks of comprehensive rehabilitation training,and the control group was given 12 weeks of comprehensive rehabilitation training,the Fugl-Meyer scale(FMA)and Berg balance scale(BBS)were used to evaluate the motor function and balance ability of lower limbs,modified Barthel index(MBI)was used to evaluate the activities of daily living,the quality of life of the patients was evaluated by SS-QOL,the surface electromyogra⁃phy(sEMG),the fastest walking speed(10m MWS)and stride length of the lower limbs of the two groups were al⁃so examined.Results The scores of FMA and BBS in the observation group after intervention were(29.10±2.15)and(49.92±4.10),respectively,which were significantly higher than those in the control group(P<0.05).The idi⁃cates the root mean square value(RMS)of EMG of rectus femoris muscle,hamstring muscle,anterior tibia muscle and medial head of gastrocnemius muscle in the observation group were(71.19±8.81)μV,(54.49±5.72)μV,(53.15±2.80)μV and(51.12±4.42)μV,respectively,which were significantly higher than those in the control group(P<0.05).After intervention,10m MWS and stride length in the observation group were(42.54±3.54)m/min and(90.54±8.82)cm,respectively,which were significantly higher than those in the control group(P<0.05).After intervention,the MBI and SS-QOL in the observation group were(89.92±6.87)and(92.39±9.45)points respectively,which were significantly higher than those in the control group(P<0.05).Conclusion RAGT combined with 12-week comprehensive rehabilitation training can significantly improve the gait and quality of life of stroke patients,which is worthy of clinical use.