机器人辅助训练下脊髓损伤患者康复效果的Meta分析

Meta analysis of the rehabilitation effect in patients with spinal cord injury under robot-assisted training

目的系统评价机器人辅助训练对脊髓损伤(SCI)患者康复效果的影响。方法计算机检索Cochrane Library、PubMed、Web of Science、Medline、中国期刊全文数据库、万方数据库、维普数据库和中国生物医学文献数据库,检索自建库以来到2020年2月有关机器人辅助训练应用于SCI患者的随机对照试验。结果共纳入11篇文献,机器人辅助训练组在6 min步行距离(MD=0.34,95%CI:0.03~0.64,P=0.03),脊髓独立测试(MD=12.38,95%CI:7.44~17.32,P<0.0001)、下肢运动评分(MD=2.43,95%CI:0.29~4.57,P=0.03),脊髓损伤步行指数(MD=3.10,95%CI:1.72~4.29,P<0.00001)、计时起立-行走测试(MD=0.58,95%CI:0.15~1.01,P=0.009)要优于对照组;但在10 m步行速度(MD=-0.02,95%CI:-0.04~0.00,P=0.12)、伯拉格平衡量表评分上(MD=-2.01,95%CI:-5.09~1.07,P=0.20)2组间差异无统计学意义。结论机器人辅助训练可提高患者的步行距离和日常生活能力,增强双下肢运动功能、步行灵活性及起立行走能力;但在提高患者步行速度和平衡能力的效果尚不确定。

Objective To systematically evaluate the effect of robot-assisted training on the rehabilitation of patients with spinal cord injury.Methods Cochrane Library,PubMed,Web of Science,Medline,Chinese Journal Full-text Database,Wanfang Database,VIP Database,and China Biomedical Literature Database were searched by computer.Randomized controlled trials of robot-assisted training in patients with spinal cord injury were retrieved from the inception of the database to February 2020.Results A total of 11 literatures were included.The robot-assisted training group at 6-minute walking distance(MD=0.34,95%CI was 0.03-0.64,P=0.03),spinal cord independent test(MD=12.38,95%CI was 7.44-17.32,P<0.0001),lower extremity motor score(MD=2.43,95%CI was 0.29-4.57,P=0.03),spinal cord injury walking index(MD=3.10,95%CI was 1.72-4.29,P<0.00001),timed standing up-walking test(MD=0.58,95%CI was 0.15-1.01,P=0.009)were better than the control group.However,there was no statistical difference at 10 m walking speed(MD=-0.02,95%CI was from-0.04 to 0.00,P=0.12)and Berger balance scale score(MD=-2.01,95%CI was from-5.09 to 1.07,P=0.20)between the two groups.Conclusion Robot-assisted training can improve the walking distance and daily living ability of patients,and enhance the motor function of both lower limbs,walking flexibility,and standing walking ability.However,the effect on improving walking speed and balance ability of patients is uncertain.