双侧联动机器人训练对脑卒中后上肢痉挛的疗效评价及等速肌张力测试分析

Efficacy of robot-assisted bilateral linkage training on upper limb spasticity poststroke and analysis of isokinetic muscle tone test

目的探讨双侧联动机器人训练对脑卒中后上肢痉挛的疗效,并利用等速测试仪分析患者上肢肌张力改善情况。方法选取2020年7月至2021年12月在嘉兴市第二医院康复医学中心住院的脑卒中上肢痉挛患者60例为研究对象,采用随机数字表法将患者分为治疗组30例和对照组30例。两组患者均接受常规康复治疗。在此基础上,对照组每天增加1次传统上肢作业活动训练,治疗组每天增加1次双侧联动机器人训练。于治疗前和治疗6周后,分别采用Fugl-Meyer运动功能评定上肢部分(FMA-UE)评估上肢运动功能,改良Barthel指数(MBI)评估日常生活活动能力,改良Ashworth量表(MAS)评估患者肘关节屈肌张力,等速测试系统评估肘关节被动牵伸时峰力矩(PT)值。结果治疗6周后,两组患者FMA-UE评分、MBI评分、MAS评级、5/s及120/s等速被动牵伸测试PT值均优于治疗前,且治疗组患者上述指标均优于对照组,差异均有统计学意义(均P<0.05)。结论双侧联动机器人训练可显著缓解脑卒中患者上肢痉挛,改善其上肢运动功能,提高其日常生活活动能力。

Objective To investigate the efficacy of robot-assisted bilateral linkage training on upper limb spasticity poststroke and analyze the muscle tone of the upper limb with isokinetic test system.Methods Sixty poststroke patients who visited the Second Hospital of Jiaxing from July 2020 to December 2021 were randomized into study group and control group,with 30 cases in each group.Patients in both groups received routine rehabilitation intervention.On this basis,the traditional upper limb occupational therapy was given once a day in control group,while the robot-assisted bilateral linkage training once a day was given to the study group for 6 weeks.The motor function of the upper limbs were evaluated by the Fugl-Meyer assessment upper extremity(FMA-UE)and the activities of daily living were assessed by the modified Barthel index(MBI),the elbow flexor tone was measured by the modified Ashworth scale(MAS),the peak torque(PT)at 5/s and 120/s by passive elbow extension were recorded by the isokinetic test system,before and after 6 weeks of treatment in two groups.Results After 6 weeks of treatment,the FMA-UE,MBI,MAS,PT at 5/s and 120/s of both groups were improved significantly,while the improvement was more significant in study group(all P<0.05).Conclusion The robot-assisted bilateral linkage training can significantly relieve upper limb spasm,improve upper limb motor function and the activities of daily living performance.