上肢机器人辅助疗法对恢复期脑卒中患者上肢运动功能及日常生活活动能力的效果

发布时间：2018-05-05 02:00

本文选题：脑卒中 + 上肢　；参考：《中国康复理论与实践》2016年12期

【摘要】：目的探讨上肢机器人辅助疗法对恢复期脑卒中患者上肢运动功能及日常生活活动能力的效果。方法 2016年6~9月,本院12例恢复期脑卒中患者随机分为实验组(n=6)和对照组(n=6)。两组均进行常规康复训练,对照组增加上肢重复性运动训练,实验组增加上肢机器人辅助疗法训练,每天20 min,每周5 d,共4周。治疗前后分别采用Fugl-Meyer评定量表上肢部分(FMA-UE)评定上肢及手的运动功能,改良Ashworth量表(MAS)评定肩、肘关节肌张力,功能独立性评定(FIM)评定日常生活活动能力;记录患者每次训练的运动轨迹。结果治疗后,两组FMA-UE评分及FIM评分均较治疗前改善(Z2.032,P0.05);两组间无显著性差异(t0.723,P0.05),实验组评分略优于对照组。治疗后,实验组肩关节内收、外展MAS评分及肘关节屈曲、伸展MAS评分均较治疗前改善(Z2.121,P0.05);对照组肩关节内收、外展MAS评分均较治疗前降低(Z2.000,P0.05),肘关节屈曲、伸展MAS评分较治疗前无显著性差异(Z1.890,P0.05),但评分略低于治疗前。治疗后,实验组各项MAS评分较对照组均无显著性差异(Z1.734,P0.05),但评分略低于对照组。系统记录的患者进行直线触点运动时的运动轨迹,由最开始的杂乱无章逐渐变得有规律性,运动控制能力有所提高。结论上肢机器人辅助疗法可促进恢复期脑卒中患者上肢运动功能及日常生活活动能力的改善,效果与重复性运动训练相似。
[Abstract]:Objective to investigate the effect of upper limb robot assisted therapy on upper limb motor function and activities of daily living (ADL) in convalescent stroke patients. Methods from June to September, 2016, 12 patients with convalescent stroke in our hospital were randomly divided into two groups: experimental group (n = 12) and control group (n = 6). Both groups received routine rehabilitation training, the control group increased the repetitive exercise training of upper limb, and the experimental group increased the training of robot assisted therapy of upper limb for 20 minutes per day for 5 days per week for 4 weeks. Before and after treatment, the motor function of upper extremity and hand was assessed by Fugl-Meyer, and the ability of daily living (ADL) was evaluated by using modified Ashworth scale (MASA) to assess shoulder, elbow muscle tension and functional independence. Record the movement track of each training. Results after treatment, the FMA-UE score and FIM score of the two groups were improved compared with those of the control group, and there was no significant difference between the two groups, and the score of the experimental group was slightly better than that of the control group. After treatment, the shoulder joint adduction, abduction MAS score, elbow flexion and extension MAS score in the experimental group were improved compared with those before treatment, and the shoulder adduction and abduction MAS scores in the control group were lower than those before treatment. There was no significant difference in stretching MAS score between before and after treatment, but the score was slightly lower than that before treatment. After treatment, the scores of MAS in the experimental group were not significantly different from those in the control group, but the scores were slightly lower than those in the control group. The track of motion recorded by the patients with linear contact motion was gradually changed into regularity from the initial disorder, and the motion control ability was improved. Conclusion Adjuvant therapy of upper limb robot can promote the improvement of upper limb motor function and activity of daily living in convalescent stroke patients, and the effect is similar to that of repetitive exercise training.
【作者单位】：首都医科大学康复医学院;中国康复研究中心北京博爱医院作业疗法科;中国科学院自动化研究所复杂系统管理与控制国家重点实验室;中国康复研究中心北京博爱医院神经康复科;中国康复研究中心北京博爱医院脊髓脊柱损伤外科;
【分类号】：R743.3;R493

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