下肢康复机器人改善痉挛型脑性瘫痪儿童步行移动功能的物理治疗研究进展

doi:10.3969/j.issn.1006-9771.2021.02.008

摘要/Abstract

摘要：

步行是中枢神经系统的终极目标在生物力学水平上的体现，对儿童心理和运动独立性的形成均有重要意义。痉挛型脑瘫儿童需要提高步行功能以获得独立的移动能力，改善日常生活质量。传统的步行训练操作标准无法规范统一，评定指标不能标准量化。下肢康复机器人以高强度、重复性运动为特征，是近年来改善神经疾患步行移动功能领域的研究热点。本文简单介绍下肢康复机器人的发展、分类和康复机制，并以《国际功能、残疾和健康分类》为框架总结机器人辅助步态训练在痉挛型脑瘫儿童步行移动功能障碍康复中的应用。下肢康复机器人对改善痉挛型脑瘫儿童下肢关节活动度、肌力和步态时空参数效果显著，对短期运动和平衡功能有明显改善，但对降低异常肌张力、减少能量消耗和提高参与能力方面研究尚存争议，对长期疗效及干预措施的标准仍需深入研究。今后需进行大样本的多中心研究，使下肢康复机器人作为传统物理治疗的补充手段为痉挛型脑瘫儿童进行全方位的量化治疗。

关键词: 康复机器人, 下肢, 痉挛型脑瘫, 步态, 综述

Abstract:

Walking is the embodiment of the ultimate goal of the central nervous system at the level of biomechanics, which is of great significance to the formation of children's psychological and motor independence. It is necessary to improve walking mobile function to obtain independent mobile ability and the quality of daily life. The standard of routine walking training cannot be unified, and the evaluation index cannot be standardized and quantified. Robot-assisted lower limb rehabilitation is the research hotspot in the field of improving walking mobile function in neurological dysfunction in recent years, which is characterized by high-intensity and repetitive locomotion. This paper briefly introduced the development, classification and rehabilitation mechanism of robot-assisted lower limb rehabilitation, and summarized the application of robot-assisted gait training in the rehabilitation of walking mobile dysfunction of children with spastic cerebral palsy based on the framework of International Classification of Functioning, Disability and Health. Robot-assisted lower limb rehabilitation can significantly improve the range of motion, muscle strength and spatiotemporal parameters of spastic cerebral palsy, and significantly improve the short-term motor and balance function. However, the researches on reducing abnormal muscle tone, reducing energy expenditure and improving participation ability are still controversial, and the standard of long-term efficacy and intervention measures still needs to be further studied. In the future, it is necessary to carry out multi-center research with large samples, so that the robot-assisted lower limb rehabilitation can be used as a supplementary mean of routine physical therapy for children with spastic cerebral palsy.

Key words: robot-assisted rehabilitation, lower limb, spastic cerebral palsy, gait, review

中图分类号:

R742.3

马婷婷,张皓. 下肢康复机器人改善痉挛型脑性瘫痪儿童步行移动功能的物理治疗研究进展[J]. 《中国康复理论与实践》, 2021, 27(2): 171-176.

Ting-ting MA,Hao ZHANG. Advance in Physiotherapy of Robot-assisted Lower Limb Rehabilitation for Walking Function in Children with Spastic Cerebral Palsy (review)[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2021, 27(2): 171-176.

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