任务导向性上肢康复机器人对乳腺癌术后继发性淋巴水肿患者肩关节运动障碍的影响

关键词：继发性淋巴水肿  关节松动术  综合消肿疗法  肩关节运动功能障碍  上肢康复外骨骼机器人训练

Keywords:secondary lymphedema  joint mobilization  complete decongestive therapy  shoulder joint dysfunction  upper-limb exoskeleton robot training

摘要：

      摘要 目的：探讨上肢康复外骨骼机器人康复训练融合综合消肿疗法对继发性淋巴水肿患者的肩关节运动功能障碍的影响。 方法：本研究于2023年7月至2024年7月期间，在郑州大学附属郑州中心医院康复科选取了64例乳腺癌术后淋巴水肿肩功能运动障碍患者。采用随机数字表法，将患者随机分为对照组（n=32）和试验组（n=32）。两组患者均接受常规康复治疗，在此基础上，对照组接受了综合消肿疗法联合关节松动技术治疗，试验组接受了综合消肿疗法联合上肢康复外骨骼机器人治疗，治疗周期均为4周。采用肩关节活动度、肌力和疼痛评分，对患者治疗前后的肩关节功能障碍进行评定。 结果：治疗前，对照组和试验组患者在肩关节活动度、肌力和疼痛评分均无显著性（P>0.05），确保了试验对象在基线特征上的一致性。治疗后，试验组患者在肩关节活动度、肌力以及疼痛评分方面的改善程度显著优于对照组，且两组间的差异达到了统计学上的显著性水平（P＜0.05）。 结论：上肢康复外骨骼机器人联合综合消肿疗法治疗乳腺癌术后淋巴水肿患者的肩关节功能障碍，较传统的关节松动术疗效更佳，显著改善肩关节活动度、肌力及疼痛评分。

Abstract:

      Abstract Objective：To investigate the effects of task-oriented upper-limb exoskeleton-assisted training combined with complete decongestive therapy（CDT） on shoulder dysfunction in patients with breast cancer-related secondary lymphedema. Method：From July 2023 to July 2024， 64 patients with postoperative breast cancer-related lymphedema and shoulder dysfunction were enrolled from the Rehabilitation Department of Zhengzhou Central Hospital Affiliated with Zhengzhou University. Using a random number table method， patients were divided into a control group （n=32） and an experimental group （n=32）. Both groups received conventional rehabilitation therapy. Additionally， the control group underwent CDT combined with joint mobilization， while the experimental group received CDT combined with upper-limb exoskeleton robot assisted training. The treatment duration was 4 weeks for both groups. Shoulder joint range of motion （ROM）， muscle strength， and pain scores were assessed before and after treatment to evaluate improvements in shoulder dysfunction. Result：No significant differences were observed between the control and experimental groups in shoulder ROM， muscle strength， or pain scores （P>0.05） at baseline. After treatment， the experimental group demonstrated significantly greater improvements in shoulder ROM， muscle strength， and pain scores compared to the control group（all P<0.05）. Conclusion：In patients with breast cancer-related secondary lymphedema, combining CDT with task-oriented upper-limb exoskeleton-assisted training yields superior improvements in shoulder ROM, muscle strength and pain reduction relative to CDT plus joint mobilization.