《中国康复理论与实践》

《中国康复理论与实践》

• 临床研究 • 上一篇    下一篇

足下垂助行仪联合Lokomat下肢康复机器人对脑卒中患者步行功能的疗效①

刘燕平1,2，罗佳3，杨京辉4，马启寿1，符卫卫1   

  1. 1.福建中医药大学附属康复医院，福建福州市350003；2.福建省康复产业研究院，福建福州市350003；3.福建中医药大学康复医学院，福建福州市350000；4.浙江省立同德医院，浙江杭州市310000。
  • 出版日期:2016-08-25 发布日期:2016-09-22

Effects of Lokomat Robotic-assisted Gait Training Combined with Drop Foot Stimulator on Gait Function in Patients with Stroke

LIU Yan-ping1,2, LUO Jia3, YANG Jing-hui4, MA Qi-shou1, FU Wei-wei1   

  1. 1. Fujian University of Traditional Chinese Medicine Affiliated Rehabilitation Hospital, Fuzhou, Fujian 350003, China; 2. Fujian Provincial Rehabilitation Industrial Institution, Fuzhou, Fujian 350003, China; 3. School of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350000, China; 4. Tongde Hospital of Zhejiang Province, Hangzhou, Zhejiang 310000, China
  • Published:2016-08-25 Online:2016-09-22

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摘要： 目的观察足下垂助行仪训练联合Lokomat 下肢康复机器人对脑卒中患者步行功能的影响。方法将36 例脑卒中患者随机分为对照组(n=18)和观察组(n=18)。两组均接受常规康复训练。对照组在常规康复治疗的基础上进行Lokomat 下肢康复机器人步行训练，观察组在对照组基础上佩戴足下垂助行仪。30 min/次，1 次/d，5 d/周，共6 周。治疗前后分别采用Fugl-Meyer 下肢运动功能量表(FMA-LL)、功能性步行量表(FAC)和足印分析法评定下肢运动功能、步行能力和步态。结果治疗前，两组FMA-LL评分、FAC分级、步态参数(步速、步宽、两侧步长差)均无显著性差异(t<0.765, Z=0, P>0.05)。治疗后，两组FMA评分、FAC分级和步速均有提高，两侧步长差与步宽均减小(t>2.190, Z>3.630, P<0.05)；观察组FMA评分、FAC分级、步速及两侧步长差均优于对照组(t>2.030, Z=-2.560, P<0.05)，但两组间步宽无显著性差异(t=0.570, P>0.05)。结论足下垂助行仪联合Lokomat 下肢康复机器人同步治疗可提高脑卒中患者的步行能力，且疗效明显优于单用Lokomat下肢康复机器人治疗。

关键词: 脑卒中, 下肢康复机器人, 足下垂助行仪, 步行功能

Abstract: Objective To investigate the effects of Lokomat robotic- assisted gait training combined with drop foot stimulator on gait function in patients with stroke. Methods Thirty-six stroke patients were randomly divided into control group (n=18) and observation group (n=18). Both groups received routine rehabilitation training. The control group accepted Lokomat robotic-assisted gait training, while the observation group worn drop foot stimulator in addition. The training intensity was 30 minutes every day, five days per week for 6 weeks. Fugl-Meyer Assessment-Lower Limb (FMA-LL), Functional Ambulation Category (FAC) and footprint analysis were used to evaluate the motor ability of lower limbs, walking ability and gait before and after training. Results There was no significant difference in the scores of FMA-LL, FAC and gait parameters (walking speed, stride width, stride length difference) before training (t<0.765, Z=0, P>0.05). The scores of FMA-LL, FAC and walking speed improved, and the stride width and stride length difference decreased after training (t>2.190, Z>3.630, P<0.05). After training, the scores of FMA-LL, FAC, walking speed and stride length difference were better in the observation group than in the control group (t>2.030, Z=-2.560, P<0.05), however, there was no significant difference in stride width between two groups (t=0.570, P>0.05). Conclusion Lokomat robotic-assisted gait training combined with foot drop stimulator could improve the lower limb motor function and gait ability in patients with stroke, and the effect might be better than using Lokomat robotic-assisted gait training only.

Key words: stroke, robotic-assisted gait training, foot drop stimulator, gait function