智能下肢康复机器人辅助步行训练对卒中后偏侧忽略患者步行功能的疗效研究

关键词：脑卒中  偏侧忽略  重复经颅磁刺激  机器人辅助步行训练  步态分析系统

Keywords:stroke  hemispatial neglect  repeated transcranial magnetic stimulation  robot-assisted walking training  gait analysis system

摘要：

      摘要 目的：探讨采用智能下肢康复机器人进行步态训练能否提高脑卒中后偏侧忽略患者的步行能力。 方法：将40例脑卒中后偏侧忽略的患者随机分为对照组和试验组各20例。每组患者均给予脑卒中常规药物治疗、重复经颅磁刺激（rTMS）及常规的康复训练，试验组采用机器人辅助步态训练，对照组采用常规的行走训练。检测并比较两组患者治疗前后偏侧忽略症状评分、Fugl-Meyer下肢运动功能（FMA-LE）评分、步态参数（步速、步幅时间、步频、步长时间差、着地冲击力差）。 结果：①两组患者的一般资料无显著性差异（均P＞0.05）；②治疗后，两组患者线段二等分、线段划消、星形划消的评分均有改善（均P＜0.05）；③两组患者FMA-LE量表治疗后的评分均优于治疗前（均P＜0.01），但是试验组的改善程度更大（P＜0.01）；④治疗后，两组患者的步速、步幅时间、步频、步长时间差、着地冲击力差均有改善（均P＜0.01），试验组的改善程度更大（P＜0.01）。 结论：在改善偏侧忽略症状的同时，脑卒中后的偏侧忽略患者可以通过智能下肢康复机器人辅助步行训练改善其步行能力。

Abstract:

      Abstract Objective： To explore whether gait training facilitated by an intelligent lower limb rehabilitation robot can enhance the walking capabilities of post-stroke patients with hemineglect. Method： A total of forty patients， who had suffered from hemilateral neglect post-stroke， were randomly assigned to either a control group or an experimental group， with twenty individuals in each. All patients received conventional pharmacotherapy， repetitive transcranial magnetic stimulation （rTMS）， and standard rehabilitation training. Additionally， the experimental group underwent robot-assisted gait training， whereas the control group was engaged in traditional walking training. Parameters such as hemineglect symptom scores， Fugl-Meyer assessment for lower extremity （FMA-LE） scores， and various gait metrics （including stride speed， stride length time， stride frequency， stride length time disparity， and impact difference） were evaluated and compared between both groups pre- and post-treatment. Result： Initially， no significant disparities were observed in the baseline data of the two groups （all P>0.05）. Subsequently， improvements in line segmentation， line bisecting， and star cancellation test scores were noted in both groups post-treatment （all P<0.05）. Moreover， the post-treatment FMA-LE scores exhibited a significant enhancement compared to the pre-treatment scores （all P<0.01）， with the experimental group demonstrating a more pronounced improvement （P<0.01）. Furthermore， post-treatment assessments indicated notable advancements in walking speed， stride length time， stride frequency， stride length time variance， and impact difference in both groups （all P<0.01）， with the experimental group showing superior progress （P<0.01）. Conclusion： The findings suggest that gait training using an intelligent lower limb rehabilitation robot not only ameliorates hemineglect symptoms but also significantly improves the walking abilities of stroke patients afflicted with hemineglect.