基于任务导向的三维机器人辅助训练对脑卒中上肢康复的效果研究

关键词：脑卒中  上肢机器人  任务导向训练

Keywords:stroke  upper limb robots  task oriented training

摘要：

      摘要 目的：探讨基于任务导向的三维上肢机器人训练对恢复期脑卒中患者上肢功能的治疗效果。 方法：选取昆明长和天城康复医院作业治疗部门2023年1—12月卒中患者45例，随机分为试验组（n=23）和对照组（n=22）。对照组进行常规康复治疗，60min/次；试验组进行“常规康复治疗+EMU辅助治疗”，（40min+20min）/次。两组共干预4周，5次/周，1次/天。治疗前后分别采用Fugl-Meyer上肢运动功能评估（Fugl-Meyer assessment-upper extremity， FMA-UE）、改良Barthel指数（modified Barthel index，MBI）、表面肌电图（surface electromyography， sEMG）对上肢运动功能、日常生活活动能力、肌肉激活与协同（肱二头肌、肱三头肌）进行评估。 结果：治疗前，两组FMA-UE、MBI、肌肉激活与协同比较无显著性差异（P>0.05）；治疗后，两组FMA-UE、MBI、肌肉激活与协同评估均有改善，且试验组FMA-UE、肌肉协同评估优于对照组（P＜0.05）；MBI、肌肉激活评估两组无显著差异（P>0.05）。 结论：基于任务导向的三维上肢机器人训练在改善上肢功能和肌肉协同能力方面具优势。

Abstract:

      Abstract Objective： To explore the effect of task oriented 3D upper limb robot training on upper limb function in patients with subacute stroke. Method： Forty-five stroke patients from the occupational therapy department of Kunming Changhe Tiancheng Rehabilitation Hospital from January to December 2023 were selected and randomly divided into an experimental group （n=23） and a control group （n=22）. The control group received occupational therapy for 60 min per session； the experimental group received routine occupational therapy combined with robot-assisted EMU adjuvant therapy for 60 min （40min+20min） per session. Both groups were intervened for a total of 4 weeks， 5 times per week. Before and after treatment， the Fugl-Meyer upper limb assessment scale （FMA-UE）， modified Barthel index （MBI）， and surface electromyography （sEMG） were used to evaluate upper limb motor function， daily living activity， muscle activation and synergy （biceps and triceps）. Result： Before treatment， there was no significant difference in FMA-UE， MBI， muscle activation， and synergy between the two groups （P>0.05）. After treatment， both groups showed improvements in FMA-UE， MBI， muscle activation， and synergistic evaluation. The experimental group demonstrated significantly greater improvements in FMA-UE scores and muscle synergistic evaluation than the control group （P<0.05）. There was no significant difference in MBI and muscle activation assessment between the two groups （P>0.05）. Conclusion： Task-oriented 3D robot-assisted training may have more advantages in improving post-stroke patient’s upper limb function and muscle synergy compared to conventional occupational therapy alone. Further studies are warranted to determine optimal training parameters and long-term effects.