外骨骼康复机器人联合虚拟现实跑台训练对脑损伤患者肢体运动功能障碍康复效果的影响

Effect of exoskeleton rehabilitation robot combined with virtual reality treadmill training on rehabilitation effect of limb motor dysfunction in patients with brain injury

目的 探讨外骨骼康复机器人联合虚拟现实跑台训练对脑损伤患者肢体运动功能障碍康复效果的影响。方法 采用便利抽样法选取2021年3月至2023年3月首都医科大学附属北京康复医院收治的96例脑损伤患者为研究对象。按照随机数字表法分为对照组和观察组,各48例。对照组给予常规康复干预,观察组在对照组基础上给予外骨骼康复机器人联合虚拟现实跑台训练,2组均干预1个月。比较2组干预前后的关节活动度、功能性步态评价表(FGA)评分、行走状态、6 min步行试验(6MWT)距离、Fugl-Meyer运动功能评定量表(FMA)评分、Berg平衡量表(BBS)评分和改良Barthel指数(MBI)评分。结果 干预1个月,2组肩关节外展、髋关节外展、膝关节屈曲活动度均大于干预前,且观察组均大于对照组(均P<0.05);观察组步速、步频均高于对照组,步行周期、摆动相时长、支撑相时长均短于对照组(均P<0.05);2组6MWT距离、FMA评分、BBS评分长于/高于干预前,且观察组长于/高于对照组[(161±13)m比(148±11)m、(72±4)分比(66±5)分、(41±5)分比(35±5)分](t=5.187、6.709、6.281,均P<0.001)。干预2周、1个月,2组MBI评分均高于干预前,且观察组均高于对照组[(69±3)分比(64±4)分、(81±3)分比(76±4)分](t=5.827、7.811,均P<0.001)。结论 在脑损伤患者肢体运动功能障碍康复中,采取外骨骼康复机器人联合虚拟现实跑台训练,能提高患者肢体活动度及独立生活能力,改善运动姿态,促进运动能力及步行能力的恢复。

Objective To explore the effect of exoskeleton rehabilitation robot combined with virtual reality treadmill training on the rehabilitation effect of limb motor dysfunction in patients with brain injury.Methods Totally 96 patients with brain injury admitted to Beijing Rehabilitation Hospital,Capital Medical University from March 2021 to March 2023 were selected as the study subjects by the convenience sampling method.They were divided into control group and observation group by the random number table method,with 48 cases in each group.The control group received routine rehabilitation intervention,while the observation group received exoskeleton rehabilitation robot combined with virtual reality treadmill training on the basis of the control group,both groups were intervened for one month.The joint range of motion,functional gait assessment(FGA)score,walking status,6 min walking test(6MWT)distance,Fugl-Meyer motor function assessment(FMA)score,Berg balance scale(BBS)score,and modified Barthel index(MBI)score were compared before and after the intervention in two groups.Results One month after intervention,the range of motion of shoulder joint abduction,hip joint abduction,and knee joint flexion in the two groups were all greater than those before intervention,and those in the observation group were greater than those in the control group(all P<0.05);the observation group had higher gait speed and frequency than the control group,and shorter walking cycles,swing phase duration,and support phase duration than the control group(all P<0.05);the 6MWT distance,FMA score,and BBS score of the two groups were longer/higher than those before intervention,and those in the observation group were longer/higher than those in the control group[(161±13)m vs(148±11)m,(72±4)vs(66±5),(41±5)vs(35±5)](t=5.187,6.709,6.281,all P<0.001).After 2 weeks and 1 month of intervention,the MBI scores of both groups were higher than those before intervention,and the observation group were higher than the control group[(69±3)vs(64±4),(81±3)vs(76±4)](t=5.827,7.811,both P<0.001).Conclusion In the rehabilitation of limb motor dysfunction in patients with brain injury,exoskeleton rehabilitation robot combined with virtual reality treadmill training can improve the patients′limb mobility and the independent living ability,improve the movement posture,and promote the recovery of movement ability and walking ability.