康复机器人结合动作观察疗法对脑卒中患者上肢运动功能康复的影响

摘要
图/表
参考文献
相关文章 (15)

全文: PDF (935 KB)
输出: BibTeX | EndNote (RIS)

摘要目的观察康复机器人结合动作观察疗法对脑卒中患者上肢运动功能康复的作用。方法选择2022年4-12月在联勤保障部队大连康复疗养中心就诊的初发脑卒中患者46例(病程＜3个月)。利用随机数字表法将入选患者分为对照组及试验组,每组23人。两组均接受常规康复治疗及上肢康复机器人训练。上肢康复机器人训练前,试验组采用动作观察疗法观看与上肢有关的日常生活动作和活动视频, 之后患者想象自己利用患侧上肢完成这些动作;对照组观看英文字母、汉字、几何图形或没有动物及人的视频。治疗前、治疗4周,采用简式Fugl-Meyer运动功能评分-上肢部分(FMA-UE)、运动评定量表上肢部分(MAS-UE)、改良Barthel指数(MBI)对两组患者进行上肢功能评定。结果治疗前,两组患者FMA-UE、MAS-UE、MBI评分均无统计学差异(P＞0.05);治疗后,两组FMA-UE、MAS-UE、MBI均显著提高(P＜0.001);治疗后,试验组FMA-UE(P＝0.039)、MAS-UE(P＝0.027)、MBI(P＝0.004)高于对照组,差异具有统计学意义。结论康复机器人结合动作观察疗法,能够进一步改善脑卒中患者的上肢运功功能,提高日常生活活动能力。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	唐迪
	王方
	王心刚
	李月
	崔向红
	刘东杰
	王丽丽

关键词 ：脑卒中, 上肢康复机器人, 动作观察疗法, 上肢, 运动

Abstract：Objective To explore the effect of rehabilitation robot combined with action observation therapy on the rehabilitation of upper limb motor function in patients with stroke.Methods A total of 46 patients with initial stroke (disease course <3 months) selected from Dalian Rehabilitation and Recuperation Center from April to December 2022 were randomly divided into control group(n=23)and observation group(n=23). Both groups received routine rehabilitation treatment and upper limb robot-assisted therapy. Before the training of robot-assisted therapy, the observation group watched the videos about activities and movements of upper limb, and then were asked to imagine their affected upper limb to complete these activities and movements. The control group watched the videos of geometric figures, letters and others without body or animals. Before treatment and 4 weeks after treatment,they were evaluated with simplified Fugl-Meyer Assessment-Upper Extremities (FMA-UE), Motor Assessment Scale-Upper Extremities (MAS-UE) and modified Barthel Index (MBI).Results Before treatment, there were no significant differences in FMA-UE, MAS-UE and MBI scores between the two groups (P>0.05). After treatment, FMA-UE, MAS-UE and MBI significantly increased in both groups (P<0.001). After treatment, FMA-UE (P=0.039), MAS-UE (P=0.027) and MBI (P=0.004) in the observation group were higher than those in the control group, and the differences were statistically significant.Conclusions Rehabilitation robot combined with action observation therapy can further improve the upper limb motor function and the ability of daily living of stroke patients.

Key words： stroke upper limb rehabilitation robot action observation therapy upper limb motor

收稿日期: 2023-09-15

ZTFLH:

R493

基金资助:军队某课题资助

通讯作者: 王方,E-mail:dlkflyzxkx@126.com

作者简介: 唐迪,博士,副主任医师。

引用本文:

唐迪, 王方, 王心刚, 李月, 崔向红, 刘东杰, 王丽丽. 康复机器人结合动作观察疗法对脑卒中患者上肢运动功能康复的影响[J]. 武警医学, 2024, 35(2): 112-115. TANG Di, WANG Fang, WANG Xingang, LI Yue, CUI Xianghong, LIU Dongjie, WANG Lili. Effect of rehabilitation robot combined with action observation therapy on rehabilitation of upper limb motor function in stroke patients. Med. J. Chin. Peop. Armed Poli. Forc., 2024, 35(2): 112-115.

链接本文:

http://journal08.magtechjournal.com/Jwk_wjyx/CN/ 或 http://journal08.magtechjournal.com/Jwk_wjyx/CN/Y2024/V35/I2/112

[5]	余灵, 喻洪流. 上肢康复机器人研究进展[J]. 生物医学工程学进展, 2020, 41(3): 134-143.
[1]	中国心血管健康与疾病报告编写组. 中国心血管健康与疾病报告2020概要[J]. 中国循环杂志, 2021, 36(6): 521-545.
[6]	中华医学会神经病学分会中华医学会神经病学分会脑血管病学组. 中国急性缺血性脑卒中诊治指南2014[J]. 中华神经科杂志, 2015, 48(4): 146-153.
[2]	Coscia M, Maximilian J W, Chaudary U, et al. Neurotechnology-aided interventions for upper limb motor rehabilitation in severe chronic stroke [J]. Brain, 2019, 142(8): 2182-2197.
[7]	梁森, 蔡庆, 陈曦, 等.任务导向训练改善脑卒中患者上肢运动功能和日常生活能力的系统评价[J] 中华物理医学与康复杂志, 2021, 43(8): 744-747.
[3]	贾杰.“中枢-外周-中枢”闭环康复——脑卒中后手功能康复新理念[J]. 中国康复医学杂志, 2016, 31(11): 1180-1182.
[8]	李宏建. 慢性卒中患者上肢感觉再学习的有效性和可行性[J].国际脑血管病杂志, 2022, 30(3): 200-201.
[4]	Bai Z, Zhang J, Zhang Z, et al. Comparison between movement-based and task-based mirror therapies on improving upper limb functions in patients with stroke: a pilot randomized controlled trial [J]. Front Neurol, 2019, 10(10): 288-298.
[9]	王平, 刘爱贤. 上肢康复机器人对脑卒中患者上肢功能康复的临床疗效观察[J]. 医学综述, 2019, 25(12): 2492-2496.
[5]	余灵, 喻洪流. 上肢康复机器人研究进展[J]. 生物医学工程学进展, 2020, 41(3): 134-143.
[10]	Franceschini M, Goffredo M, Pournajaf S, et al. Predictors of activities of daily living outcomes after upper limb robot-assisted therapy in subacute stroke patients [J]. PLoS One, 2018, 13(2): e0193235.
[6]	中华医学会神经病学分会中华医学会神经病学分会脑血管病学组. 中国急性缺血性脑卒中诊治指南2014[J]. 中华神经科杂志, 2015, 48(4): 146-153.
[11]	何艳, 张通. 机器人辅助训练对脑卒中患者上肢功能的效果[J]. 中国康复理论与实践, 2021, 27(7): 797-801.
[7]	梁森, 蔡庆, 陈曦, 等.任务导向训练改善脑卒中患者上肢运动功能和日常生活能力的系统评价[J] 中华物理医学与康复杂志, 2021, 43(8): 744-747.
[12]	Rodgers H, Shaw L, Bosomworth H, et al. Robot assisted training for the upper limb after stroke (ratuls): study protocol for a randomised controlled trial [J]. Trials, 2017, 18(1): 340.
[8]	李宏建. 慢性卒中患者上肢感觉再学习的有效性和可行性[J].国际脑血管病杂志, 2022, 30(3): 200-201.
[13]	Iwamoto Y, Imura T, Suzukawa T, et al. Combination of exoskeletal upper limb robot and occupational therapy improve activities of daily living function in acute stroke patients [J]. J Stroke Cerebrovascul Dis, 2019, 28(7): 2018-2025.
[9]	王平, 刘爱贤. 上肢康复机器人对脑卒中患者上肢功能康复的临床疗效观察[J]. 医学综述, 2019, 25(12): 2492-2496.
[14]	胡洁,朱琳,刘霖, 等. 上肢康复机器人结合常规康复训练对急性期脑卒中患者上肢功能的疗效研究[J]. 中国康复, 2018, 33(6): 448-450.
[10]	Franceschini M, Goffredo M, Pournajaf S, et al. Predictors of activities of daily living outcomes after upper limb robot-assisted therapy in subacute stroke patients [J]. PLoS One, 2018, 13(2): e0193235.
[15]	Zhang J Q, Fong K N, Welage N, et al. The activation of the mirror neuron system during action observation and action execution with mirror visual feedback in stroke: a systematic review[J]. Neural Plast, 2018:2321045.
[11]	何艳, 张通. 机器人辅助训练对脑卒中患者上肢功能的效果[J]. 中国康复理论与实践, 2021, 27(7): 797-801.
[16]	Molenberghs P, Cunnington R, Mattingley J B. Brain regions with mirror properties: a meta-analysis of 125 human fMRI studies[J]. Neurosci Biobehav Rev,2012,36:341-349.
[12]	Rodgers H, Shaw L, Bosomworth H, et al. Robot assisted training for the upper limb after stroke (ratuls): study protocol for a randomised controlled trial [J]. Trials, 2017, 18(1): 340.
[17]	Saleh S, Yarossi M, Manuweera T, et al. Network interactions underlying mirror feedback in stroke: a dynamic causal modeling study[J]. Neuroimage Clin,2017,13:46-54.
[13]	Iwamoto Y, Imura T, Suzukawa T, et al. Combination of exoskeletal upper limb robot and occupational therapy improve activities of daily living function in acute stroke patients [J]. J Stroke Cerebrovascul Dis, 2019, 28(7): 2018-2025.
[18]	沈芳, 刘虎, 顾旭东, 等. 动作观察法对缺血性脑卒中患者上肢运动功能恢复的影响[J].中国物理医学与康复杂志, 2017, 39(3): 184-188.
[14]	胡洁,朱琳,刘霖, 等. 上肢康复机器人结合常规康复训练对急性期脑卒中患者上肢功能的疗效研究[J]. 中国康复, 2018, 33(6): 448-450.
[19]	Rosenthal O, Wing A M, Wyatt J L, et al. Boosting robot-assisted rehabilitation of stroke hemiparesis by individualized selection of upper limb movements: a pilot study [J]. J Neuroeng Rehabil, 2019, 16(1): 42.
[15]	Zhang J Q, Fong K N, Welage N, et al. The activation of the mirror neuron system during action observation and action execution with mirror visual feedback in stroke: a systematic review[J]. Neural Plast, 2018:2321045.
[20]	Mehrholz J, Pohl M, Platz T, et al. Electromechanical and robot-assisted arm training for improving activities of daily living, arm function, and arm muscle strength after stroke [J]. Cochrane Database Syst Rev, 2018, 9(9): CD006876.
[16]	Molenberghs P, Cunnington R, Mattingley J B. Brain regions with mirror properties: a meta-analysis of 125 human fMRI studies[J]. Neurosci Biobehav Rev,2012,36:341-349.
[21]	苏丽丽, 方小养, 林玲, 等. 上肢机器人训练对脑卒中偏瘫患者上肢功能影响的研究[J]. 数理医药学杂志, 2021, 34(6): 910-912.
[17]	Saleh S, Yarossi M, Manuweera T, et al. Network interactions underlying mirror feedback in stroke: a dynamic causal modeling study[J]. Neuroimage Clin,2017,13:46-54.
[18]	沈芳, 刘虎, 顾旭东, 等. 动作观察法对缺血性脑卒中患者上肢运动功能恢复的影响[J].中国物理医学与康复杂志, 2017, 39(3): 184-188.
[19]	Rosenthal O, Wing A M, Wyatt J L, et al. Boosting robot-assisted rehabilitation of stroke hemiparesis by individualized selection of upper limb movements: a pilot study [J]. J Neuroeng Rehabil, 2019, 16(1): 42.
[20]	Mehrholz J, Pohl M, Platz T, et al. Electromechanical and robot-assisted arm training for improving activities of daily living, arm function, and arm muscle strength after stroke [J]. Cochrane Database Syst Rev, 2018, 9(9): CD006876.
[21]	苏丽丽, 方小养, 林玲, 等. 上肢机器人训练对脑卒中偏瘫患者上肢功能影响的研究[J]. 数理医药学杂志, 2021, 34(6): 910-912.