上肢康复机器人辅助训练对卒中后上肢痉挛伴肩关节半脱位患者运动功能的作用

发布时间：2018-06-04 19:25

本文选题：卒中 + 肩关节半脱位　；参考：《中国脑血管病杂志》2016年06期

【摘要】：目的探讨上肢康复机器人辅助训练对卒中后上肢痉挛伴肩关节半脱位患者运动功能的康复作用。方法回顾性纳入2015年3月至12月卒中后上肢痉挛伴肩关节半脱位的患者40例,采用数字表法将患者随机分为机器人组和对照组各20例。对照组患者采用常规康复治疗,40 min/次。机器人组在常规康复的基础上增加上肢康复机器人训练,30 min/次。两组患者训练均为2次/d,10次/周。均于治疗前及治疗后6周进行运动功能及日常生活能力评定。通过测量患者坐位患肩肩峰至肱骨头间距(AHI)评定肩关节半脱位距离;采用改良Ashworth量表(MAS)评定痉挛程度;采用简式Fugl-Meyer运动功能评分(FMA)评价上肢运动功能;改良Barthel指数(MBI)量表评价日常生活能力。结果治疗前两组患者基线指标比较,差异无统计学意义(P0.05)。治疗后6周,机器人组的AHI值从治疗前的(22.7±1.2)mm降至(10.6±1.2)mm;MAS评分从治疗前的(2.01±0.28)分降至(0.59±0.23)分,差异均有统计学意义(均P0.05);FMA从治疗前的(30±9)分升至(54±8)分;MBI从治疗前的(44±8)分升至(83±10)分;差异均有统计学意义(均P0.05)。治疗后机器人组的AHI值及MAS、FMA和MBI评分明显优于对照组(t值分别为-4.009、-6.846,2.938和5.548,均P0.05)。结论上肢康复机器人辅助训练能够改善卒中后患者的上肢痉挛伴肩关节半脱位状态,促进患者运动功能和日常生活能力的提高。
[Abstract]:Objective to investigate the rehabilitation effect of upper limb rehabilitation robot assisted training on motor function of patients with spasm of upper extremity and subluxation of shoulder joint after stroke. Methods Forty patients with upper limb spasm with shoulder subluxation after stroke from March to December 2015 were enrolled retrospectively. The patients were randomly divided into two groups: the robot group and the control group. Patients in the control group were treated with routine rehabilitation for 40 min/. On the basis of routine rehabilitation, the robot group increased the training time of upper limb rehabilitation robot for 30 min/. The two groups of patients were trained twice / d 10 times a week. Motor function and ADL were evaluated before and 6 weeks after treatment. The distance of shoulder subluxation was assessed by measuring the distance between shoulder acromium and humerus head in sitting position, the degree of spasm was assessed by modified Ashworth scale, and the motor function of upper extremity was evaluated by simple Fugl-Meyer motor function score. The activity of daily living (ADL) was evaluated by modified Barthel index. Results there was no significant difference in baseline indexes between the two groups before treatment (P 0.05). Six weeks after treatment, the AHI score of the robot group decreased from 22.7 卤1.2)mm to 10.6 卤1.2mm Mas from 2.01 卤0.28 to 0.59 卤0.23, and the difference was statistically significant (all P0.05FMAs increased from 30 卤9 to 54 卤8) and the score of MBI increased from 44 卤8 to 83 卤10). The difference was statistically significant (P 0.05). After treatment, the AHI, MASM and MBI scores in the robot group were significantly higher than those in the control group (-4.009 ~ 6.846 卤2.938 and 5.548, respectively, P < 0.05). Conclusion the upper limb rehabilitation robot assisted training can improve the upper limb spasm with shoulder subluxation after stroke and promote the improvement of patients' motor function and daily living ability.
【作者单位】：首都医科大学宣武医院康复医学科;
【分类号】：R743.3;R684.7

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