体位限制下康复机器人训练对脑卒中后肩关节半脱位患者上肢功能的效果

doi:10.3969/j.issn.1006-9771.2024.03.007

Abstract

Abstract:

Objective To explore the effect of robotic training under position limitation on upper limb of patients with shoulder subluxation after stroke.

Methods From March to December, 2023, sixty patients with shoulder subluxation after stroke in the First Affiliated Hospital of Bengbu Medical University were randomized into conventional group (n = 20), robot group (n = 20) and position-limited group (n = 20). All the groups accepted conventional rehabilitation, while the robot group underwent robot training and the position-limited group underwent robot training under position limitation, for four weeks. Before and after treatment, Fugl-Meyer Assessment-Upper Extremities (FMA-UE) and modified Barthel Index (MBI) were used for evaluation, surface electromyography (sEMG) was used to measure the average electromyography (AEMG) and root mean square (RMS) of posterior deltoid fasciculus and supraspinatus during contraction, and musculoskeletal ultrasonography was used to determine the distance of acromion-greater tuberosity (AGT) of the affected side.

Results After treatment, FMA-UE score, MBI score, AEMG, RMS and the distance of AGT improved in all the groups (|t| > 10.850, P< 0.001), and all the indexes were optimal in the position-limited group (F> 42.031, P< 0.001).

Conclusion Robotic training for upper limb under postural limitation can further improve upper limb function and subluxation status, activities of daily living, and peri-shoulder muscle in patients with shoulder subluxation after stroke.

Key words: stroke, shoulder subluxation, upper extremity robot, rehabilitation

CLC Number:

R743.3

LIU Huan, HAN Xue, SONG Jianing, LOU Xiaole, XU Lei. Effect of robotic training under position limitation on upper limbs in patients with shoulder subluxation after stroke[J]. Chinese Journal of Rehabilitation Theory and Practice, 2024, 30(3): 303-309.

Figures/Tables 8

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References 36

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组别	n	性别(男/女)/n	年龄/岁	病程/d	患侧(左/右)/n	性质(出血/梗死)/n
常规组	20	14/6	58.85±10.16	58.40±15.47	13/7	9/11
机器人组	20	13/7	54.90±9.22	53.35±12.87	12/8	9/11
体位限制组	20	12/8	59.85±11.52	57.70±13.45	12/8	10/10
χ²/F值		0.440	1.217	0.728	0.141	0.134
P值		0.803	0.304	0.487	0.932	0.935

组别	n	治疗前	治疗后	t值	P值
常规组	20	24.10±1.48	32.20±1.29	-18.899	< 0.001
机器人组	20	24.05±1.36	35.20±1.29^a	-27.932	< 0.001
体位限制组	20	24.30±1.58	38.00±1.45^a,b	-33.331	< 0.001
F值		0.152	88.480
P值		0.859	< 0.001

组别	n	治疗前	治疗后	t值	P值
常规组	20	50.55±1.56	58.90±1.37	-17.915	< 0.001
机器人组	20	50.35±1.68	63.15±1.39^a	-26.128	< 0.001
体位限制组	20	50.50±1.69	65.85±1.39^a,b	-29.264	< 0.001
F值		0.076	121.797
P值		0.927	< 0.001

组别	n	治疗前	治疗后	t值	P值
常规组	20	18.90±1.84	30.65±1.59	-25.976	< 0.001
机器人组	20	19.00±1.45	34.00±1.45^a	-28.401	< 0.001
体位限制组	20	18.95±1.91	35.85±1.85^a,b	-34.384	< 0.001
F值		0.016	49.163
P值		0.985	< 0.001

组别	n	治疗前	治疗后	t值	P值
常规组	20	23.35±1.68	38.05±1.43	-36.334	< 0.001
机器人组	20	23.95±1.56	42.00±1.45^a	-45.069	< 0.001
体位限制组	20	23.80±1.69	44.35±1.71^a,b	-43.463	< 0.001
F值		0.683	81.660
P值		0.509	< 0.001

Effect of robotic training under position limitation on upper limbs in patients with shoulder subluxation after stroke

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组别	n	治疗前	治疗后	t值	P值
常规组	20	17.00±1.90	32.00±1.90	-26.473	< 0.001
机器人组	20	17.90±1.84	37.15±1.68^a	-31.083	< 0.001
体位限制组	20	17.60±2.13	40.00±1.90^{a, b}	-38.778	< 0.001
F值		1.038	93.456
P值		0.361	< 0.001

组别	n	治疗前	治疗后	t值	P值
常规组	20	22.10±1.37	35.20±1.66	-29.726	< 0.001
机器人组	20	21.45±1.88	39.25±1.61^a	-28.407	< 0.001
体位限制组	20	21.00±1.90	41.05±1.43^a,b	-40.111	< 0.001
F值		1.929	69.198
P值		0.155	< 0.001

组别	n	治疗前	治疗后	t值	P值
常规组	20	3.15±0.17	2.56±0.17	10.850	< 0.001
机器人组	20	3.20±0.18	2.20±0.22^a	14.430	< 0.001
体位限制组	20	3.13±0.14	2.01±0.16^a,b	19.326	< 0.001
F值		1.030	42.031
P值		0.363	< 0.001

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