摘要
目的:采用Meta分析法探讨下肢外骨骼机器人对脑卒中患者时空步态的影响。方法:计算机检索国内外数据库有关于下肢外骨骼机器人对脑卒中患者步态功能恢复的随机对照研究。以步长、步速、步频、步宽、步行周期、步态时相为结局指标,使用Cochrane手册5.1.0进行偏倚风险评估工具和改良Jadad量表对纳入文献进行质量评价。运用Revmen5.4和Stata 17.0软件进行统计学分析。结果:最终纳入15篇文献,共713例患者。Meta分析结果显示,与对照组相比,试验组的步长[MD=2.61,95%CI:(1.79,3.44),P<0.0001],步速[MD=0.08,95%CI:(0.07,0.09),P<0.0001],步频[MD=6.10,95%CI:(3.67,8.53),P<0.0001],步宽[MD=-2.22,95%CI:(-2.93,-1.51),P<0.0001],步态时相[MD=-0.08,95%CI:(-0.11,-0.06),P<0.0001],合并效应有显著差异,并有统计学意义。步行周期显示与对照组相比没有显著差异,[MD=-0.01,95%CI:(-0.37,0.35),P=0.94]。亚组分析结果表明,基于平台训练的机器人与对照组相比更好地改善了步长、步速、步频。下肢外骨骼机器人对病程<6个月的患者,干预效果良好,且治疗周期越长效果越明显。结论:下肢外骨骼机器人能更好地改善卒中患者的时空步态参数,提高步行能力。
Objective:Meta-analysis was used to explore the effect of a lower extremity exoskeleton robot on the spatio-temporal gait of stroke patients.Method:The domestic and foreign databases for randomized controlled studies of lower limb exoskeleton robots on gait function recovery in stroke patients were searched.Step length,step speed,cadence,step width,walking cycle,and gait phase were used as outcome indicators.The Cochrane Handbook 5.1.0 was used as a bias risk assessment tool,and the modified Jadad scale was used to evaluate the quality of the included literature.Statistical analysis was performed using Revmen 5.4 and Stata 17.0 software.Results:A total of 15 articles with 713 patients were included.Meta-analysis revealed a significant difference in merger effect between the experimental group and the control group:the step length[MD=2.61,95%CI:(1.79,3.44)],step speed[MD=0.08,95%CI:(0.07,0.09)],cadence[MD=6.10,95%CI:(3.67,8.53),P=0.0001],step width[MD=-2.22,95%CI:(-2.93,-1.51),P<0.0001],and gait phase[MD=-0.08,95%CI:(-0.11,-0.06),P<0.0001].There was no significant difference in the walking cycle between the two groups[MD=-0.01,95%CI:(-0.37,0.35),P=0.94].The results of the subgroup analysis showed that the platform-based training robot improved step length,step speed,and cadence compared to the control group.The lower limb exoskeleton robot had a good intervention effect on patients with a disease duration of less than 6 months,and the effect was more pronounced when the treatment period prolonged.Conclusion:Lower-limb exoskeleton robots can better improve temporal and spatial gait parameters and walking ability in stroke patients.
作者
洪雅晴
刘铨权
张清芳
段丽红
柯美华
支亮
龙建军
Hong Yaqing;Liu Quanquan;Zhang Qingfang(School of Rehabilitation Medicine,Shandong University of Traditional Chinese Medicine,Jinan 250355,China)
出处
《中国康复》
2023年第12期739-747,共9页
Chinese Journal of Rehabilitation
基金
广东省医学科研基金项目资助课题(A2021169)
深圳市第二人民医院项目资助课题(2023xgyj3357006)
深圳市三名工程“南京医科大学励建安团队”资助项目(No.SZSM202111010)。