摘要：

目的 探讨下肢康复机器人训练对脑卒中偏瘫患者下肢运动功能的康复作用。 方法 共60 例发病< 6 个月的脑卒中偏瘫患者随机接受常规康复训练联合减重步行训练（BWSTT 组，30 例）或常规康复训练联合下肢康复机器人训练（Robot 组，30 例），分别于训练前和训练8 周时采用Fugl-Meyer 下肢评价量表（FMA-LE）评价下肢运动功能、Berg 平衡量表（BBS）评价平衡功能、下肢康复机器人力矩反馈系统评价下肢肌力。 结果 与训练前相比，两组患者训练8 周时FMA-LE（P = 0.000）和BBS（P =0.000）评分、步态周期中患侧髋关节（P = 0.000）和膝关节（P = 0.000）反馈力矩值均增加；与BWSTT 组相比，训练8 周时Robot 组仅步态周期中患侧髋关节（P = 0.000）和膝关节（P = 0.000）反馈力矩值增加。 结论 常规康复训练联合减重步行训练和下肢康复机器人训练均可以改善脑卒中偏瘫患者下肢运动功能，下肢康复机器人训练在提高下肢肌力方面优于减重步行训练。

关键词: 卒中, 偏瘫, 运动障碍, 下肢, 机器人, 康复

Abstract:

Objective  To observe the rehabilitation effect of lower limb rehabilitation robot training on the lower limb motor function of hemiplegic patients after stroke.  Methods  A total of 60 stroke patients (duration < 6 months) accepted conventional rehabilitation training combined with body weight support treadmill training (BWSTT group, N = 30) or conventional rehabilitation training combined with lower limb rehabilitation robot training (Robot group, N = 30). Fugl - Meyer Assessment Scale for Lower Extremity (FMA-LE) was used to evaluate lower limb motor function. Berg Balance Scale (BBS) was used to evaluate balance function. Lower limb rehabilitation robot torque feedback system was used to evaluate lower limb muscle strength. All evaluations were performed before and after 8-week training.   Results  Compared with before training, the FMA-LE score (P = 0.000), BBS score (P = 0.000), hemiplegic side of hip joint feedback torque value (HJTV, P = 0.000) and knee joint feedback torque value (KJTV, P = 0.000) were increased in both groups after 8-week training. Compared with BWSTT group, the hemiplegic side of HJTV (P = 0.000) and KJTV (P = 0.000) were increased in Robot group after 8-week training, while the FMA-LE score (P = 0.118) and BBS score (P = 0.159) had no statistically significant difference between 2 groups.  Conclusions  The lower limb rehabilitation robot or body weight support treadmill training combined with conventional rehabilitation training could improve the lower limb motor function of hemiplegic patients after stroke. The lower limb rehabilitation robot training was better than body weight support treadmill training on the recovery of lower limb muscle strength.

Key words: Stroke, Hemiplegia, Movement disorders, Lower extremity, Robotics, Rehabilitation