Lokomat机器人辅助步行训练对偏瘫儿童下肢运动功能的效果

doi:10.3969/j.issn.1006-9771.2025.06.012

《中国康复理论与实践》 ›› 2025, Vol. 31 ›› Issue (6): 711-720.doi: 10.3969/j.issn.1006-9771.2025.06.012

Lokomat机器人辅助步行训练对偏瘫儿童下肢运动功能的效果

周天添¹^,^2a, 张通¹^,^2b(), 张琦¹^,^2a, 梁艳华¹^,^2a, 张燕庆¹^,^2a, 岳青¹^,^2a, 李思佳¹^,^2a

1.首都医科大学康复医学院，北京市 100068
2.中国康复研究中心北京博爱医院，a.儿童物理疗法科；b.神经康复科，北京市 100068

收稿日期:2025-03-13 修回日期:2025-05-15 出版日期:2025-06-25 发布日期:2025-06-16
通讯作者: 张通(1961-)，男，汉族，北京市人，博士，主任医师，博士研究生导师，主要研究方向：神经康复。E-mail： Tom611@126.com E-mail:Tom611@126.com
作者简介:周天添(1995-)，女，汉族，江苏海安市人，硕士，主管技师，主要研究方向：儿童运动康复。

Effect of Lokomat robotic-assisted gait training on lower limb motor function in children with hemiplegia

ZHOU Tiantian¹^,^2a, ZHANG Tong¹^,^2b(), ZHANG Qi¹^,^2a, LIANG Yanhua¹^,^2a, ZHANG Yanqing¹^,^2a, YUE Qing¹^,^2a, LI Sijia¹^,^2a

1. Capital Medical University School of Rehabilitation Medicine, Beijing 100068, China
2a. Department of Pediatric Physical Therapy; b. Department of Neurology, Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing 100068, China

Received:2025-03-13 Revised:2025-05-15 Published:2025-06-25 Online:2025-06-16
Contact: E-mail: Tom611@126.com E-mail:Tom611@126.com

摘要/Abstract

摘要：

目的探讨Lokomat机器人辅助步行训练对偏瘫儿童下肢运动功能的影响。

方法 2023年10月至2025年1月，北京博爱医院收治的偏瘫儿童52例，随机分为对照组(n = 26)和观察组(n = 26)。两组均接受常规康复治疗，观察组增加Lokomat机器人辅助步行训练，共4周。干预前后，比较10米步行测试的自选步行速度(SWS)和最大步行速度(MWS)、6分钟步行距离(6MWD)、生理消耗指数(PCI)以及步态线长度比、单支撑线比、站立相比和步长比。

结果干预后，两组SWS、MWS和6MWD均明显改善(|Z| > 2.910, P < 0.01)，观察组优于对照组(|Z| > 2.069, P < 0.05)；两组PCI均显著降低(|Z| > 4.458, P < 0.001)，观察组优于对照组(Z = -2.435, P < 0.05)；两组步态线长度比、单支撑线比和站立相比均增加(Z = 3.398, |t| > 2.211, P < 0.05)，且观察组优于对照组(Z = 2.802, |t| > 2.107, P < 0.05)。

结论 Lokomat机器人辅助步行训练可以提高偏瘫儿童的步行速度和步行耐力，降低能量消耗，提高步行效率，改善步态的对称性。

关键词: 偏瘫, 儿童, 机器人辅助步行训练, 下肢, 运动功能

Abstract:

Objective To explore the effect of Lokomat robotic-assisted gait training on lower limb motor function in children with hemiplegia.

Methods From October, 2023 to January, 2025, a total of 52 children with hemiplegia admitted to Beijing Bo'ai Hospital were randomly divided into control group (n = 26) and observation group (n = 26). Both groups received conventional rehabilitation therapy, while the observation group additionally received Lokomat robotic-assisted gait training, for four weeks. Before and after intervention, the self-selected walking speed (SWS) and maximum walking speed (MWS) of 10-meter Walk Test, 6-minute walking distance (6MWD), Physiological Cost Index (PCI), as well as gait line length asymmetry ratio, single support line asymmetry ratio, stance phase asymmetry ratio and step length ratio were compared.

Results After intervention, SWS, MWS and 6MWD improved in both groups (|Z| > 2.910, P < 0.01), and were better in the the observation group than in the control group (|Z| > 2.069, P < 0.05); PCI significantly decreased in both groups (|Z| > 4.458, P < 0.001), and was lower in the observation group than in the control group (Z = -2.435, P < 0.05); the gait line length asymmetry ratio, single support line asymmetry ratio and stance phase asymmetry ratio improved in both groups (Z = 3.398, |t| > 2.211, P < 0.05), and were better in the observation group than in the control group (Z = 2.802, |t| > 2.107, P< 0.05).

Conclusion Lokomat robotic-assisted gait training can effectively improve walking speed and endurance in children with hemiplegia, reduce energy expenditure, enhance walking efficiency, and promote gait symmetry, thereby facilitating symmetrical gait patterns.

Key words: hemiplegia, children, robotic-assisted gait training, lower limb, motor function

中图分类号:

R742.3

周天添, 张通, 张琦, 梁艳华, 张燕庆, 岳青, 李思佳. Lokomat机器人辅助步行训练对偏瘫儿童下肢运动功能的效果[J]. 《中国康复理论与实践》, 2025, 31(6): 711-720.

ZHOU Tiantian, ZHANG Tong, ZHANG Qi, LIANG Yanhua, ZHANG Yanqing, YUE Qing, LI Sijia. Effect of Lokomat robotic-assisted gait training on lower limb motor function in children with hemiplegia[J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(6): 711-720.

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组别	n	性别 (男/女)/n	年龄/岁	Brunnstorm分期 (Ⅲ/Ⅳ)/n
对照组	26	15/11	9.23±1.86	13/13
观察组	26	13/13	9.27±1.97	12/14
χ²/t值		0.310	0.072	0.077
P值		0.578	0.943	0.781

变量	组别	n	测试	M(Q_L, Q_U)	Z值	P值
SWS/m·s^-1	对照组	26	前测	0.91(0.57, 1.07)	-3.205	0.001
			后测	0.99(0.72, 1.11)
	观察组	26	前测	0.80(0.62, 1.05)	-4.461	< 0.001
			后测	1.08(0.90, 1.19)
	治疗前差值			0.05(-0.36, 0.29)	-0.293	0.770
	治疗后差值			-0.08(-0.42, -0.10)	-2.069	0.039
MWS/m·s^-1	对照组	26	前测	1.32(1.00, 1.46)	-2.910	0.004
			后测	1.36(1.13, 1.50)
	观察组	26	前测	1.22(1.07, 1.41)	-4.461	< 0.001
			后测	1.49(1.29, 1.64)
	治疗前差值			0.02(-0.35, 0.32)	-0.430	0.667
	治疗后差值			-0.22(-0.44, -0.11)	-2.069	0.039
6MWD/m	对照组	26	前测	397.51(294.50, 415.00)	-3.975	< 0.001
			后测	404.99(339.17, 432.27)
	观察组	26	前测	358.66(298.79, 410.00)	-4.457	< 0.001
			后测	442.56(366.24, 479.28)
	治疗前差值			5.33(-101.29, 110.04)	-0.805	0.421
	治疗后差值			-19.56(-119.93, 37.77)	-2.224	0.026

组别	n	测试	M(Q_L, Q_U)	Z值	P值
对照组	26	前测	1.07(0.86, 1.43)	-4.458	< 0.001
		后测	0.83(0.65, 1.16)
观察组	26	前测	1.00(0.86, 1.26)	-4.459	< 0.001
		后测	0.68(0.55, 0.85)
治疗前差值			0.08(-0.42, 0.45)	-0.595	0.552
治疗后差值			0.24(-0.08, 0.48)	-2.435	0.015

组别	n	测试	M(Q_L, Q_U)	Z值	P值
对照组	26	前测	0.73(0.66, 0.90)	-3.398	< 0.001
		后测	0.83(0.69, 0.92)
观察组	26	前测	0.84(0.66, 0.92)	-4.435	< 0.001
		后测	0.95(0.87, 1.00)
治疗前差值			0.02(-0.20, 0.09)	-0.586	0.558
治疗后差值			-0.07(-0.23, -0.08)	-2.802	0.005

组别	n	测试	$\bar{x} \pm s$	t值	P值
对照组	26	前测	0.38±0.19	-3.565	0.001
		后测	0.44±0.17
观察组	26	前测	0.40±0.18	-7.140	< 0.001
		后测	0.60±0.22
治疗前均值差			-0.02±0.22	0.375	0.709
治疗后均值差			-0.16±0.27	2.922	0.005

Lokomat机器人辅助步行训练对偏瘫儿童下肢运动功能的效果

Effect of Lokomat robotic-assisted gait training on lower limb motor function in children with hemiplegia

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组别	n	测试	$\bar{x} \pm s$	t值	P值
对照组	26	前测	0.92±0.05	-2.211	0.036
		后测	0.94±0.04
观察组	26	前测	0.93±0.04	-4.847	< 0.001
		后测	0.97±0.04
治疗前均值差			-0.01±0.06	0.551	0.584
治疗后均值差			-0.02±0.05	2.107	0.040

组别	n	测试	M(Q_L, Q_U)	Z值	P值
对照组	26	前测	1.08(0.92, 1.19)	-0.229	0.819
		后测	1.09(0.96, 1.19)
观察组	26	前测	1.09(0.95, 1.15)	-0.903	0.367
		后测	1.04(0.95, 1.14)
治疗前差值			0.02(-0.19, 0.16)	-0.311	0.756
治疗后差值			0.07(-0.09, 0.17)	-0.706	0.480

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