《中国康复理论与实践》 ›› 2026, Vol. 32 ›› Issue (6): 645-652.doi: 10.3969/j.issn.1006-9771.2026.06.003
高惠刚1a,2, 刘远文2, 秦煜玲1a,3, 胡昔权1a,2, 朱琳1a,1b,1c(
)
收稿日期:2025-07-30
修回日期:2025-12-26
出版日期:2026-06-25
发布日期:2026-06-24
通讯作者:
朱琳,E-mail: 11251@gzsport.edu.cn作者简介:高惠刚(1989-),男,汉族,广东佛山市人,硕士研究生,主要研究方向:慢性病与老年康复、神经康复。基金资助:
GAO Huigang1a,2, LIU Yuanwen2, QIN Yuling1a,3, HU Xiquan1a,2, ZHU Lin1a,1b,1c(
)
Received:2025-07-30
Revised:2025-12-26
Published:2026-06-25
Online:2026-06-24
Contact:
ZHU Lin, E-mail: 11251@gzsport.edu.cn
Supported by:摘要:
目的 探索足踝软体外骨骼机器人(ASRE)干预脑卒中患者步行功能的效果。
方法 系统检索PubMed、Embase、Scopus、Web of Science、中国知网、万方和维普等数据库2020年1月1日至2025年5月1日间评估ASRE对脑卒中偏瘫患者步行功能影响的研究,采用PEDro量表及非随机对照试验研究偏倚风险工具对纳入文献进行质量评价,提取数据进行Scoping综述。
结果 最终纳入12项研究,包括随机对照试验3项、交叉对照试验3项、前后对照试验6项,来自中国、美国和韩国3个国家,共涉及256例患者。3项随机对照试验为高质量,其余试验偏倚风险为中等和严重。5项研究为单次干预,7项为多次干预,多次干预方案为每次30~60 min,每周2~5次,共5~20次。ASRE可改善步行速度、步行距离、偏瘫侧推进力、步态参数与时空对称性、关节活动度,以及与下肢运动、平衡、步态相关的量表结果,安全性和可靠性表现良好。
结论 ASRE可能有助于改善脑卒中患者的步行功能。
中图分类号:
高惠刚, 刘远文, 秦煜玲, 胡昔权, 朱琳. 2020年至2025年足踝软体外骨骼机器人改善脑卒中患者步行功能的Scoping综述[J]. 《中国康复理论与实践》, 2026, 32(6): 645-652.
GAO Huigang, LIU Yuanwen, QIN Yuling, HU Xiquan, ZHU Lin. Effect of ankle soft robotic exosuit on gait function for stroke patients: a scoping review from 2020 to 2025[J]. Chinese Journal of Rehabilitation Theory and Practice, 2026, 32(6): 645-652.
表3
非RCT文献ROBINS-I评价"
| 纳入文献 | 混杂偏倚 | 选择受试者偏倚 | 干预分类偏倚 | 偏离干预偏倚 | 缺失数据偏倚 | 结局测量偏倚 | 选择性报告偏倚 | 总体偏倚风险等级 |
|---|---|---|---|---|---|---|---|---|
| Awad等[ | ± | + | + | + | + | + | + | ± |
| Awad等[ | - | - | + | + | + | + | + | - |
| Shin等[ | - | - | + | + | + | + | + | - |
| Nuckols等[ | - | ± | + | + | + | + | + | - |
| Porciuncula等[ | - | - | + | + | + | + | + | - |
| Sloot等[ | ± | + | + | + | + | + | + | ± |
| Swaminathan等[ | ± | + | + | + | + | + | + | ± |
| Cataldo等[ | ± | + | + | + | + | ± | + | ± |
| Lee等[ | ± | + | + | + | + | ± | + | ± |
表4
纳入文献基本特征"
| 纳入文献 | 实验设计 | 地区 | n | 年龄/岁 | 病程 | 设备/质量 | 比较 | 干预方案 | 评价指标 | 主要结果 |
|---|---|---|---|---|---|---|---|---|---|---|
| Awad等[ | 前后对照 | 美国 | 36 | 57 | 7.3年 | ReWalkReStoreTM/5 kg | 干预前后 | 每次40 min,共5次 | 最大步行速度、不良事件发生率、故障率 | 步行速度提高,不良事件发生率、故障率低 |
| Awad等[ | 前后对照 | 美国 | 6 | 52 | 4.2年 | ReWalkReStoreTM/5 kg | WE vs. UWE | 单次 | 10MWT、6MWT、能量消耗 | 步行速度、距离提高,能量消耗无变化 |
| Yeung等[ | RCT | 中国 | 47 | 66 | 27 d | 自研ASRE设备/0.5 kg | 组内、组间比较(UWE) | 每次30 min,共20次(10周) | 10MWT、BBS、FAC | 步行速度提高,BBS、FAC评分提高 |
| Shin等[ | 前后对照 | 美国 | 5 | 46 | 2.7年 | ReWalkReStoreTM/5 kg | 干预后vs.干预前(UWE) | 每次30 min,共18次(6~8周) | 10MWT、6MWT、FGA、TUGT、FMA-LE、2MWT、关节运动角度、时空对称性 | 步行速度、距离提高,关节运动角度增加,角度对称性增加,FGA、TUGT、FMA-LE评分改善 |
| Nuckols等[ | 前后对照 | 美国 | 4 | 49 | 12.3年 | 软体踝关节外骨骼/3.8 kg | 干预后vs.干预前(UWE) WE vs. UWE | 每次60 min,平均训练15.5次(4周) | 偏瘫侧推进力、每日步数 | 2例偏瘫侧推进力、每日步数增加,另外2例无变化 |
| Porciuncula等[ | 交叉对照 | 美国 | 4 | 49 | 3.8年 | ReWalkReStoreTM/5 kg | 干预后vs.干预前(UWE) | 每次30 min,共6次(2周,洗脱期6周) | 10MWT、6MWT、偏瘫侧推进力、踝关节扭矩、拖曳肢体角度、步长 | 步行速度、距离提高,3例偏瘫侧推进力提高,步幅提高 |
| Sloot等[ | 前后对照 | 美国 | 19 | 53 | 8年 | 软体踝关节外骨骼/2 kg | WE vs. UWE | 单次 | 步行速度、偏瘫侧推进力、摆动期离地间隙、足部着地角度、能量消耗、行走稳定性、小腿肌肉活动 | 步行速度提高,偏瘫侧推进力提高,踝背屈角度增加,足廓清能力提高 |
| Swaminathan等[ | 前后对照 | 美国 | 9 | 52 | 9.5年 | 软体踝关节外骨骼 | WE,不同阻力与无阻力比较 | 单次 | 峰值推进力、推进冲量、推进冲量对称性、踝关节峰值扭矩及功率、腓肠肌与胫前肌活动、患侧膝伸展角度、患侧肢体拖曳角度、非偏瘫侧GRFV | 峰值推进力提高,踝关节扭矩、功率增加 |
| Xie等[ | RCT | 中国 | 30 | 61 | 8.4周 | YrobotRelinkTM/3 kg | 组内、组间比较(UWE) | 每次30 min,共10次(2周) | 10MWT、6MWT、FAC、FMA-LE、BBS、时空参数和步态对称性 | 步行速度、距离提高,FMA-LE得分改善,步态对称性改善,步长增加(有组间差异) |
| Cataldo等[ | 交叉对照 | 美国 | 11 | 58 | 8年 | ReWalkReStoreTM/5 kg | WE vs. UWE | 单次 | 步行速度、持续时间、VO2peak、BDNF水平、步态对称性 | 步行速度、持续时间、VO2peak、BDNF水平提高 |
| 吴文杰[ | RCT | 中国 | 40 | 50 | 2个月 | YrobotRelinkTM/3 kg | 组内、组间比较(UWE) | 每次30 min,共20次(4周) | 6MWT、FAC、FMA-LE、步态周期、步频、步行速度、步幅、步态对称性 | 步行速度、距离提高(无组间差异),步态对称性改善、踝关节运动角度改善,步幅、步频改善,FMA-LE评分改善 |
| Lee等[ | 交叉对照 | 韩国 | 45 | 54 | 2.8年 | GEMS-A/2.1 kg | WE vs. UWE | 单次 | 步行速度、步频、步幅、步态对称性、髋膝踝运动角度、踝关节背屈/跖屈力矩、GRFV | 步行速度提高,步态对称性改善,步幅、步长改善,关节运动角度改善 |
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