CAJ | 학술논문

目的：观察康复机器人对脑卒中偏瘫患者上肢功能恢复疗效及上肢神经传导速度的影响。方法将60例患者随机分为试验组和对照组，每组各30例。对照组给予常规肢体功能训练，包括运动疗法（ PT）和作业治疗（ OT）治疗等；试验组除给予常规肢体功能训练外，还进行上肢康复机器人治疗。入选患者分别于训练前、训练2 w、训练4 w后接受以下评定：（1）肩、肘、腕活动度（ ROM）及手握力；（2） Lindmark 评分；（3）上肢神经传导速度检测。结果治疗前，两组患者肩、肘、腕活动度（ROM）及手握力、Lindmark评分、上肢神经传导速度评分结果比较差异无统计学意义（P＞0．05）。训练4 w后，两组患者的肩、肘、腕活动度（ROM）、Lindmark评分、上肢神经传导速度评分结果：试验组和对照组均较训练前有改善（P＜0．05），部分有显著改善（P＜0．01）；试验组与对照组比较：在肩外展、肩前屈、肘屈、前臂旋前、前臂旋后、Lindmark评分和上肢神经传导速度上，试验组均优于对照组（P＜0．05），在手握力、肩内收上，试验组明显优于对照组（P＜0．01）。结论上肢康复机器人结合常规肢体功能训练能更有效地促进脑卒中偏瘫患者上肢功能的恢复，并更有效地改善偏瘫侧上肢神经的传导功能。
목적：관찰강복궤기인대뇌졸중편탄환자상지공능회복료효급상지신경전도속도적영향。방법장60례환자수궤분위시험조화대조조，매조각30례。대조조급여상규지체공능훈련，포괄운동요법（ PT）화작업치료（ OT）치료등；시험조제급여상규지체공능훈련외，환진행상지강복궤기인치료。입선환자분별우훈련전、훈련2 w、훈련4 w후접수이하평정：（1）견、주、완활동도（ ROM）급수악력；（2） Lindmark 평분；（3）상지신경전도속도검측。결과치료전，량조환자견、주、완활동도（ROM）급수악력、Lindmark평분、상지신경전도속도평분결과비교차이무통계학의의（P＞0．05）。훈련4 w후，량조환자적견、주、완활동도（ROM）、Lindmark평분、상지신경전도속도평분결과：시험조화대조조균교훈련전유개선（P＜0．05），부분유현저개선（P＜0．01）；시험조여대조조비교：재견외전、견전굴、주굴、전비선전、전비선후、Lindmark평분화상지신경전도속도상，시험조균우우대조조（P＜0．05），재수악력、견내수상，시험조명현우우대조조（P＜0．01）。결론상지강복궤기인결합상규지체공능훈련능경유효지촉진뇌졸중편탄환자상지공능적회복，병경유효지개선편탄측상지신경적전도공능。
Objective To observe the rehabilitation efficacy of stroke patients with robot-assisted training including upper limb function and nerve conduction velocity .Methods Sixty cases were randomized into control group and experiment group , thirty cases in each group.The control group was given conventional upper-limb function training,including physical therapy (PT) and occupational therapy ( OT) ,while the experiment group was given conventional upper-limb function training and robot-assisted training for upper-limb.The patients in both groups were treated for thirty minutes once a day ,five times a week,with four weeks as one period of treatment .Assess-ments were made among patients before training ,two weeks and four weeks after training ,including shoulder ,elbow,wrist range of motor (ROM) and hand grip strength,Lindmark scores,nerve conduction velocity(NCV)of the upper-limb.Results Before training,there were no statistical differences in the shoulder ,elbow,wrist ROM,hand grip strength,NCV and Lindmark scores of the upper-limb be-tween the two groups(P>0.05),but four weeks after training,the experiment group gained better scores than the control group (P<0.05),and some scores had improved significantly (P<0.01).The experiment group was better than the control group in the shoulder , elbow,wrist ROM and NCV of upper-limb(P<0.05),and had improved significantly in the hand grip strength and Lindmark scores (P<0.01).Conclusions It could be concluded that robot-assisted training gained better motor function of upper limb in stroke patients on the basis of conventional training ,and more effectively improve the nerve conduction function of hemiplegic upper limb .