下肢康复机器人训练联合镜像疗法对脑卒中偏瘫患者步态控制的影响

Effect of lower limb rehabilitation robot combined with mirror therapy on gait control of stroke patients with hemiplegia

目的探讨下肢康复机器人训练联合镜像疗法对脑卒中偏瘫患者步态控制的影响。方法选取2019年5月至2021年12月苏州明基医院收治的84例脑卒中偏瘫患者作为研究对象,随机将其分为A组、B组和联合组,每组各28例。3组患者均给予常规康复训练。在此基础上,A组患者给予下肢康复机器人训练,B组患者给予镜像疗法,联合组患者给予下肢康复机器人训练和镜像疗法。观察3组患者康复训练前后步行时空参数、Holden步行功能分级、踝背屈角、内翻角、Berg平衡功能量表评分、Barthel指数评分。结果治疗4周后,3组患者步宽较治疗前均减小(P<0.05),且联合组小于A、B组(P<0.05);步速、步频、步幅较治疗前均升高(P<0.05),且联合组高于A、B组(P<0.05);Holden步行功能分级及踝背屈角均增大,且联合组大于A、B组(P<0.05);内翻角均减小,且联合组小于A、B组(P<0.05);Berg平衡功能量表评分、Barthel指数评分较治疗前均升高(P<0.05),且联合组高于A、B组(P<0.05)。治疗4周后,A、B组步行时空参数、Holden步行功能分级、踝背屈角、内翻角、Berg平衡功能量表评分、Barthel指数评分比较差异无统计学意义(P>0.05)。结论下肢康复机器人训练联合镜像疗法用于脑卒中偏瘫患者效果明显,能够提高其步行能力,改善其生活质量。

Objective To investigate the effect of lower limb rehabilitation robot combined with mirror therapy on gait control in stroke patients with hemiplegia.Methods A total of 84 stroke patients with hemiplegia admitted to Suzhou Beno Hospital from May 2019 to December 2021 were randomly assigned to group A,group B,or combination group,with 28 cases in each group.All of them were given routine rehabilitation training.On this basis,group A was given lower limb robot‑assisted rehabilitation training,group B was given mirror therapy,and the combined group was given lower limb robot‑assisted rehabilitation training plus mirror therapy.The spatio‑temporal parameters of walking,Holden walking function grade,ankle dorsiflexion angle,varus angle,Berg balance function scale score,and Barthel index were observed before and after rehabilitation training.Results The step width of the three groups 4 weeks after treatment was significantly lower than that before treatment(P<0.05),and the step width of the combination group was significantly lower than that of groups A and B(P<0.05).The step speed,step frequency,and step length of the three groups 4 weeks after treatment were significantly higher than those before treatment(P<0.05),and these three parameters of the combination group was significantly higher than those of groups A and B(P<0.05).Holden walking function grade,ankle dorsiflexion angle,Berg balance function scale score,and Barthel index of the three groups 4 weeks after treatment were significantly higher than those before treatment(P<0.05),and the above‑mentioned parameters the combined group were higher than those in groups A and B(P<0.05).After treatment,the varus angle decreased in the 3 groups,and the varus angle in the combined group was significantly lower than that in groups A and B(P<0.05).There were no significant differences in the spatio‑temporal parameters of walking,Holden walking function grade,ankle dorsiflexion angle,varus angle,Berg balance function scale score,or Barthel index between group A and group B four weeks after treatment(P>0.05).Conclusion Lower limb rehabilitation robot combined with mirror therapy is effective in stroke patients with hemiplegia,and it can improve walking ability and quality of life.