早期悬吊保护下智能助行训练对脑卒中后运动和行走功能的效果

doi:10.3969/j.issn.1006-9771.2024.04.008

Abstract

Abstract:

Objective To explore the effect of early intelligent assisted walking under suspension protection on lower limb motor function in stroke patients with hemiplegia.

Methods From October, 2020 to March, 2023, 42 early stroke inpatients with hemiplegia from Beijing Bo'ai Hospital were randomly divided into control group (n = 21) and experimental group (n = 21). Both groups received routine rehabilitation, and the control group received routine walking training under sky rail suspension protection, while the experimental group received walking training wearing an intelligent assistive walking device under suspension protection, for four weeks. They were assessed with Fugl-Meyer Assessment (FMA), FMA-Balance (FMA-B), and wireless sensing 3D gait analysis before and after treatment.

Results The scores of FMA and FMA-B of affected limb improved in both groups, as well as the stride frequency, stride speed, affected step length, support phase of the affected limb, maximum hip joint flexion angle and maximum knee joint flexion angle of the affected limb (|t| > 2.230, P < 0.05), and they were better in the experimental group than in the control group (|t| > 2.140, P < 0.05).

Conclusion Early intervention of intelligent assisted walking training under suspension protection can improve motor and balance function, as well as walking in stroke patients with hemiplegia.

Key words: stroke, hemiplegia, intelligent assisted walking training, gait, motor, lower limb, rehabilitation

CLC Number:

R743.3

ZHENG Jianling, LIU Huilin, ZHU Lin, GU Bin, YAN Ruxiu, ZHAO Qi, SONG Luping. Effect of early intelligent assisted walking under suspension protection on motor and walking function for stroke patients[J]. Chinese Journal of Rehabilitation Theory and Practice, 2024, 30(4): 431-436.

Figures/Tables 9

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References 25

[1]	易龙. 下肢智能康复机器人在脑卒中偏瘫患者康复治疗中的应用效果及对肢体运动功能的影响[J]. 临床医学研究与实践, 2023, 8(8): 31-33.
	YI L. Application effect of lower limb intelligent rehabilitation robot in rehabilitation treatment of stroke patients with hemiplegia and its influence on limb motor function[J]. Clin Res Prac, 2023, 8(8): 31-33.
[2]	何海峰, 洪卫军, 周慧青, 等. 下肢康复机器人对脑梗死后偏瘫患者异常步态及下肢功能的改善作用[J]. 医疗装备, 2023, 36(4): 78-80.
[3]	吴雪娇, 朱玉连, 丁小琴, 等. 下肢机器人结合本体感觉神经肌肉促进技术对脑卒中患者下肢功能的临床疗效研究[J]. 中国康复医学杂志, 2020, 35(8): 938-943.
	WU X J, ZHU Y L, DING X Q, et al. The therapeutic effect of lower limb robot combined with PNF technique on lower limb function in stroke patients[J]. Chin J Rehabil Med, 2020, 35(8): 938-943.
[4]	KNUTSON J S, HANSEN K, NAGY J, et al. Contralaterally controlled neuromuscular electrical stimulation for recovery of ankle dorsiflexion: a pilot randomized controlled trial in patients with chronic post-stroke hemiplegia[J]. Am J Phys Med Rehabil, 2013, 92(8): 656-665. doi: 10.1097/PHM.0b013e31829b4c16
[5]	张楠. 一种动力型步行装置对脑卒中患者步行功能的影响[D]. 上海: 上海体育学院, 2021.
	ZHANG N. Effects of a dynamic walking device on walking function in stroke patients[D]. Shanghai: Shanghai Univ Sport, 2021.
[6]	陈芳, 黄俊豪, 吴文杰, 等. 下肢外骨骼机器人在脑卒中患者功能康复中应用进展[J]. 中国康复, 2023, 38(4): 243-247.
[7]	RODRÍGUEZ-FERNÁNDEZ A, LOBO-PRAT J, FONT-LLAGUNES J M. Systematic review on wearable lower-limb exoskeletons for gait training in neuromuscular impairments[J]. J Neuroeng Rehabil, 2021, 8(1): 22. doi: 10.1186/1743-0003-8-22
[8]	中华医学会神经病学分会, 中华医学会神经病学分会脑血管病学组. 中国各类主要脑血管病诊断要点2019[J]. 中华神经科杂志, 2019, 52(9): 710-715.
	China Society of Neurology, China Stroke Society. Diagnostic criteria of cerebrovascular diseases in China (version 2019)[J]. Chin J Neurol, 2019, 52(9): 710-715.
[9]	支芳, 吴星星. 脑卒中偏瘫患者采用早期部分减重步行训练与康复治疗临床研究[J]. 当代医学, 2018, 24(16): 162-164.
[10]	朱琳, 刘洋, 刘元旻, 等. 脑卒中患者常用下肢辅助设备干预下步态分析的对比研究[J]. 中国康复医学杂志, 2022, 37(7): 901-906.
	ZHU L, LIU Y, LIU Y M, et al. A comparative study of gait analysis in stroke patients with commonly used assistive devices[J]. Chin J Rehabil Med, 2022, 37(7): 901-906.
[11]	雷德宝, 吴校林, 朱锐, 等. 下肢机器人训练对脑卒中偏瘫患者三维步态分析系统测试结果的影响[J]. 临床和实验医学杂志, 2019, 18(12): 1323-1327.
	LEI D B, WU X L, ZHU R, et al. The influence of lower limb robot training on the results of three-dimensional gait analysis system for stroke patients with hemiplegia[J]. J Clin Exp Med, 2019, 18(12): 1323-1327.
[12]	CHOY C S, CLOHERTY S L, PIROGOVA E, et al. Virtual reality assisted motor imagery for early post-stroke recovery: a review[J]. IEEE Rev Biomed Eng, 2023, 16: 487-498. doi: 10.1109/RBME.2022.3165062
[13]	许梦雅, 朱庆华, 贾艳露, 等. 基于交互抑制理论的肢体康复锻炼操对脑卒中偏瘫患者运动和平衡功能的影响[J]. 中国实用神经疾病杂志, 2022, 25(2): 192-196.
	XU M Y, ZHU Q H, JIA Y L, et al. Influence of physical rehabilitation exercise based on interactive inhibition theory on motor and balance function of stroke patients with hemiplegia[J]. Chin J Prac Nerv Dis, 2022, 25(2): 192-196.
[14]	杨舫容. 系统髋关节强化训练在脑梗死后偏瘫老年患者康复中的疗效观察[J]. 中国医药指南, 2017, 15(6): 17-18.
[15]	刘娜, 翟宏伟, 陈伟, 等. 强化髋关节运动控制训练对偏瘫患者步行功能恢复的影响[J]. 实用医院临床杂志, 2022, 19(6): 34-36.
	LIU N, ZHAI H W, CHEN W, et al. The effect of strengthening hip joint motion control training on the recovery of walking function in hemiplegic patients[J]. Prac J Clin Med, 2022, 19(6): 34-36.
[16]	ROCHE N, BONNYAUD C, GEIGER M, et al. Relationship between hip flexion and ankle dorsiflexion during swing phase in chronic stroke patients[J]. Clin Biomech (Bristol, Avon), 2015, 30(3): 219-225. doi: 10.1016/j.clinbiomech.2015.02.001
[17]	赵飞. 髋关节强化训练对脑卒中患者动态姿势稳定性的影响[J]. 中国药物与临床, 2021, 21(12): 2135-2136.
[18]	曹海杰, 刘杰, 杨丰, 等. 髋关节强化训练对脑卒中患者动态姿势稳定性的影响[J]. 东南国防医药, 2020, 22(4): 362-366.
	CAO H J, LIU J, YANG F, et al. The effects of hip intensive training on dynamic pose stability of patients with stroke[J]. Military Med J Southeast Chin, 2020, 22(4): 362-366.
[19]	王剑桥, 刘惠林. Bobath理念在卒中后偏瘫患者步态康复中的研究进展[J]. 中国康复理论与实践, 2019, 25(6): 683-685. doi: 10.3969/j.issn.1006-9771.2019.00.004
	WANG J Q, LIU H L. Bobath concept in the process of gait rehabilitation for post-stroke patients with hemiplegia (review)[J]. Chin J Rehabil Theory Pract, 2019, 25(6): 683-685.
[20]	尹汉逵, 柏和风, 王月丽, 等. 骨盆辅助式下肢康复机器人对脑卒中偏瘫患者躯干控制及本体感觉的影响[J]. 现代实用医学, 2023, 35(11): 1456-1458.
[21]	TAY S S, VISPERAS C A, BIN ZAINUL ABIDEEN A, et al. Effectiveness of adjunct robotic therapy with a patient-guided suspension system for stroke rehabilitation using a 7-days-a-week model of care: a comparison with conventional rehabilitation[J]. Arch Rehabil Res Clin Transl, 2021, 3(3): 100144.
[22]	郑志超. 步行康复训练器及其控制策略研究[D]. 大连: 大连理工大学, 2012.
	ZHENG Z C. Research on gait rehabilitation training apparatus and its control strategy[D]. Dalian: Dalian Univ Technol, 2012.
[23]	刘光维, 胡鸾娇, 刘国纯. 脑卒中偏瘫病人主动康复训练理论研究与实践[M]. 重庆: 重庆大学出版社, 2022: 147-178.
	LIU G W, HU L J, LIU G C. Theoretical research and practice of active rehabilitation training for stroke hemiplegic patients[M]. Chongqing: Chongqing University Press, 2022: 147-178.
[24]	EMKEN J L, BENITEZ R, REINKENSMEYER D J. Human-robot cooperative movement training: learning a novel sensory motor transformation during walking with robotic assistance-as-needed[J]. J Neuroeng Rehabil, 2007, 4: 8. pmid: 17391527
[25]	王丽芳, 蔡月梅, 张秋云. 步行训练的时机选择对偏瘫患者康复的临床价值[J]. 中国社区医师, 2015(16): 144, 146.
	WANG L F, CAI Y M, ZHANG Q Y. The clinical value of timing selection for walking training in the rehabilitation of hemiplegic patients[J]. Chin Community Phys, 2015(16): 144, 146.

组别	n	性别(男/女)/n	年龄/岁	偏瘫侧(左/右)/n	下肢Brunnstrom分期(Ⅱ/Ⅲ/Ⅳ)/n
对照组	21	14/7	51.10±11.50	10/11	8/8/5
试验组	21	15/6	47.60±12.37	10/11	6/11/4
t值			-1.088
P值		1.000^a	0.290	1.000^a	1.000^a

组别	n	训练前	训练后	t值	P值
对照组	20	25.95±14.72	33.30±16.10	-8.743	< 0.001
试验组	20	33.25±20.62	51.15±22.35	-7.862	< 0.001
训练前均值差		7.30±19.16		1.289	0.206
训练后均值差			17.85±18.94	4.347	< 0.001

组别	n	训练前	训练后	t值	P值
对照组	20	6.20±2.44	8.65±2.23	-9.561	< 0.001
试验组	20	6.00±2.18	10.15±1.66	-10.758	< 0.001
训练前均值差		-0.20±3.14		-0.274	0.786
训练后均值差			1.75±2.55	3.671	0.001

组别	n	训练前	训练后	t值	P值
对照组	20	55.70±17.97	60.70±19.03	-5.910	< 0.001
试验组	20	54.50±13.21	69.10±17.41	-5.277	< 0.001
训练前均值差		-1.35±19.38		-0.241	0.811
训练后均值差			9.06±26.03	3.318	0.002

组别	n	训练前	训练后	t值	P值
对照组	20	21.15±20.60	23.90±22.61	-2.230	0.038
试验组	20	20.75±11.80	31.60±18.55	-5.248	< 0.001
训练前均值差		-1.88±21.28		-0.075	0.940
训练后均值差			6.53±24.47	2.871	0.007

Effect of early intelligent assisted walking under suspension protection on motor and walking function for stroke patients

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组别	n	训练前	训练后	t值	P值
对照组	20	14.15±11.68	18.85±12.18	-6.202	< 0.001
试验组	20	17.10±8.05	24.80±9.58	-6.286	< 0.001
训练前均值差		2.35±13.14		0.930	0.359
训练后均值差			5.12±14.43	2.140	0.039

组别	n	训练前	训练后	t值	P值
对照组	20	73.55±7.17	71.25±5.79	2.869	0.010
试验组	20	74.00±7.00	66.60±5.49	5.162	< 0.001
训练前均值差		0.45±8.41		0.201	0.842
训练后均值差			-4.65±7.63	-2.605	0.013

组别	n	训练前	训练后	t值	P值
对照组	20	15.70±9.20	19.55±9.69	-3.807	0.001
试验组	20	17.45±10.09	26.55±7.58	-7.207	< 0.001
训练前均值差		1.75±11.58		0.573	0.570
训练后均值差			7.00±8.96	3.245	0.003

组别	n	训练前	训练后	t值	P值
对照组	20	22.80±14.65	26.55±14.44	-4.589	< 0.001
试验组	20	23.45±13.35	36.85±12.52	-36.734	< 0.001
训练前均值差		0.65±16.04		0.147	0.884
训练后均值差			10.30±17.84	4.878	< 0.001

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