镜像视觉反馈训练联合下肢康复机器人对脑卒中患者下肢运动功能的影响

Effects of combining mirror visual feedback with robot-assisted gait training on the lower limb functioning of stroke survivors

目的探讨镜像视觉反馈训练联合下肢康复机器人对脑卒中患者下肢运动功能的影响。方法将60例脑卒中患者按随机数字表法分为对照组、机器人组和联合组,每组20例。3组患者均接受康复科常规康复训练,机器人组在此基础上进行4周的下肢康复机器人辅助步行训练(每次30 min、每日1次、每周5 d),联合组在机器人组基础上增加镜像视觉反馈训练(每次20 min、每日1次、每周5 d)。治疗前和治疗4周后(治疗后),采用简式Fugl-Meyer运动功能量表下肢部分(FMA-LE)、Berg平衡量表(BBS)和Holden功能性步行分级(FAC)评价患者的下肢功能和步行能力。结果治疗前,3组患者FMA-LE、BBS评分及FAC分级比较,差异无统计学意义(P>0.05)。3组患者治疗后FMA-LE、BBS评分及FAC分级均较组内治疗前有所改善(P<0.05)。机器人组治疗后FMA-LE、BBS评分及FAC分级较对照组优异(P<0.05),且联合组治疗后FMA-LE[(21.95±2.95)分]、BBS评分[(35.65±3.53)分]、FAC分级优于机器人组,差异有统计学意义(P<0.05)。结论在常规康复治疗基础上,增加下肢康复机器人训练能提高脑卒中患者的下肢运动功能和步行能力,联合镜像视觉反馈治疗的效果更显著。

Objective To investigate any effect of combining mirror visual feedback(MVF)training with robot-assisted gait training(RGT)in promoting the recovery of lower limb motor function among stroke survivors.Methods Sixty stroke survivors were randomly divided into a combined treatment group,an RGT group and a control group,each of 20.In addition to traditional rehabilitation,the RGT group received 30min of RGT 5 days a week for 4 weeks,while the combined treatment group underwent 30min of RGT and also 20min of MVF training with the same frequency and duration.Before and after the treatment,the lower extremities motor functioning and walking ability of all of the patients were assessed using the Fugl-Meyer Assessment for the lower extremities(FMA-LE),the Berg Balance Scale(BBS)and Functional Ambulation Categories(FAC).Results There were no systematic differences in any of the measurements before the treatment.After the 4 weeks,however,the average FMA-LE,BBS and FAC scores of the combined treatment and RGT groups were significantly better than the control group′s averages,and those of the combined treatment group were significantly superior to the RGT group′s.All of the groups had,however,improved significantly compared with before the treatment.Conclusions Robot-assisted gait training is more effective in enhancing the motor functioning of the lower extremities and walking ability when it is combined with MVF.