下肢康复训练机器人对缺血性脑卒中偏瘫患者平衡及步行功能的影响

关键词：下肢康复机器人  缺血性脑卒中  平衡功能  偏瘫步态  步行功能  踝关节

Keywords:lower limb gait training rehabilitation robot  ischemic stroke  balance function  hemiplegic gait  walking ability  ankle

摘要：

      摘要 目的：观察下肢康复训练机器人对缺血性脑卒中（早期）偏瘫患者平衡功能以及步行功能的影响。 方法：将40例偏瘫患者随机分为对照组（20例）和Lokomat组（20例）。两组均给予常规肢体功能训练，对照组采用常规康复疗法，每周进行3次，每次30min，共治疗10周。Lokomat组给予下肢康复机器人为主的运动训练，辅以常规康复训练，每次30min，3次/周，共10周（2个疗程）。采用Berg平衡量表及单项评分（测定平衡功能）、踝-后足评分量表（AOFAS）及其中的异常步态、前足活动（屈/伸）、后足活动（内翻加外翻）、踝-后足稳定性和足部对线（评价踝关节的功能恢复和异常步态）和步长、步宽、步频、步速（评价患者每天活动时实际步行功能的变化）进行疗效评价。 结果：治疗前，两组在Berg平衡量表，踝-后足功能评分以及异常步态、前足活动（屈/伸）、后足活动（内翻加外翻）、踝-后足稳定性和足部对线，步长、步宽、步速和步频的评测差异均无显著性（P＞0.05），均具有可比性。治疗后，Berg平衡量表，踝-后足功能评分及异常步态、前足活动（屈/伸）、后足活动（内翻加外翻）、踝-后足稳定性和足部对线，步长、步宽、步速和步频的评测较治疗前均有明显改善（P＜0.05）；与对照组相比，Lokomat组改善均更明显（P＜0.05）；Berg平衡功能单项评分比较：训练后，Lokomat组从坐到站、无支撑站位、无支撑坐位、站到坐、转移、闭眼站立、并脚站立、前后脚成直线以及单脚站等方面评分均高于对照组（P＜0.05）。 结论：下肢康复训练机器人能改善缺血性脑卒中偏瘫患者的踝背屈功能，对改善其平衡和步行功能具有积极作用。

Abstract:

      Abstract Objective: To investigate the effect of Lokomat lower limb gait training rehabilitation robot on balance function and walking ability in hemiplegic patients after ischemic stroke. Method: Forty hemiplegic patients after ischemic stroke were randomly divided into Lokomat group and control group with 20 cases in each group. The Lokomat group received Lokomat rehabilitation therapy besides routine rehabilitation training, while the control group received routine rehabilitation only. All patients were assessed at the beginning of training and after 10 week-training. The Berg balance scale (BBS), AOFAS scale and abnormal gait, forefoot activities (flex and extension), hind foot activities (varus and valgus), ankle hind leg stability, foot part line jitter; gait parameters(step length, stride width, cadence, velocity) were used to evaluate stepping function before training and after 10 week-training. Result: Before training, there was no significant difference in BBS, AOFAS scale and abnormal gait, forefoot activities(flex and extension), hind foot activities (varus and valgus), ankle hind leg stability, foot part line jitter, gait parameters between two groups. After treatment, all indexes were perfected greatly. Compared to control group, there were significant differences in Lokomat treatment group (P＜0.05). Conclusion: The Lokomat rehabilitation treatment group can improve balance function and walking ability in hemiplegic patients after stroke.