目的 研究上肢机器人治疗联合肌电生物反馈对急性脑卒中患者上肢功能的影响.方法 将急性期脑卒中患者30例按随机数字表法分为治疗组和对照组,每组15例.对照组给予常规康复治疗和肌电生物反馈治疗;治疗组在对照组治疗方案的基础上增加上肢机器人治疗.分别于治疗前、治疗3周后、治疗结束3个月后采用简式Fugl-Meyer上肢功能评分(FMA)进行上肢运动功能的评定,采用功能独立性评定量表(FIM)进行日常生活活动能力的评定.结果 治疗3周后和治疗结束3个月后,2组患者的FMA和FIM评分均显著优于组内治疗前(P<0.05);治疗3周后,2组患者的FMA评分组间差异无统计学意义(P>0.05),治疗结束3个月后,治疗组的FMA为(47.53 ±10.65)分,显著优于对照组同时间点的(34.73±8.14)分(P<0.05);而治疗3周后和治疗结束3个月后,2组患者的FIM评分组间差异无统计学意义(P>0.05).结论 上肢机器人联合肌电生物反馈可显著改善急性脑卒中患者的上肢运功功能,且疗效显著优于单纯的肌电生物反馈,但在日常生活活动能力的改善方面未见特别优势.
Objective To study the effects of robot-assisted therapy combined with electromyographic biofeedback (EMGBF) on upper limb function after stroke.Methods Thirty acute stroke patients were randomly divided into two groups of 15.The patients in the control group received a conventional rehabilitation program and EMGBF.The patients in the treatment group received robot-assisted therapy for 30 minutes daily,6 days a week for 3 weeks combined with EMGBF on the basis of the conventional rehabilitation program.Upper limb motor function and ability in the activities of daily living (ADL) were assessed with the Fugl-Meyer upper extremity assessment (FMA) and a functional independence measure (FIM) before treatment,at 3 weeks and 3 months after treatment.Results After treatment the FMA and FIM scores of both groups were significantly better than before treatment.At 3 weeks after treatment there was no significant difference in the average FMA scores of the two groups,but at 3 months after treatment the patients in the treatment group had significantly better scores.No significant differences in FIM scores were observed at 3 weeks or 3 months.Conclusions Robot-assisted therapy combined with EMGBF can improve upper limb motor function significantly in acute stroke patients,and more effectively than EMGBF.But no significant advantage in improvement in ADL performance was observed with Robot-assisted therapy combined with EMGBF over EMGBF.