下肢康复机器人对改善脑卒中偏瘫患者下肢肌力及运动功能障碍的临床研究

目的:观察下肢康复机器人训练对早期脑卒中偏瘫患者下肢肌力及运动功能的影响。方法:将50例发病6个月内的脑卒中患者随机分为试验组和对照组,每组25例。在常规康复训练的基础上,对照组给予MOTOmed智能运动系统训练,每次30min,每周5次,共治疗8周;试验组给予下肢康复机器人训练,每次30min,每周5次,共治疗8周。治疗前及治疗8周后采用徒手肌力量表(MMT)评估下肢肌力,采用简式Fugl-Meyer运动量表(FMA)评估下肢运动功能,采用下肢康复机器人数据反馈系统评估下肢肌力。结果:治疗前两组患者的一般资料、MMT评估、Fugl-Meyer评估、机器人客观数据评估差异均无显著性意义(P0.05),治疗后两组MMT评估、Fugl-Meyer评估、机器人客观数据评估差异均有显著性意义(P0.05),且试验组均优于对照组(P0.01)。结论:下肢康复机器人结合常规康复治疗能有效地改善早期脑卒中偏瘫患者下肢肌力及运动功能障碍。     

腰背肌抗阻训练对脑卒中后平衡功能和下肢运动功能的临床疗效观察

目的:探讨腰背肌抗阻训练对脑卒中后平衡功能和下肢运动功能的疗效。方法:2017年5月—2019年5月,选择符合纳入标准的患者60例,并随机分为试验组(n=30)和对照组(n=30),试验组在常规康复训练20mins的基础上,增加腰背肌抗阻训练20mins;对照组采用常规康复训练40mins。两组每日训练1次,每周5次,持续3周。分别对两组患者在治疗前、治疗3周后采用Berg平衡功能评分(Berg balance scale,BBS)、下肢Fugl-Meyer量表(Fugl-Meyer assessment lower extremity,FMA-L)、10m最大步行速度测试(10m maximum walking speed,MWS)和站起-走计时测试(time up and go test,TUGT)进行评估。结果:治疗3周后,两组患者Berg平衡功能评分、下肢Fugl-Meyer量表和10m最大步行速度测试均较治疗前均有提高(P0.05),站起-走计时测试均较治疗前有降低(P0.05);试验组Berg平衡功能评分、下肢Fugl-Meyer量表、10m最大步行速度测试和站起-走计时测试改善幅度较对照组显著(P0.05)。结论:腰背肌抗阻训练可显著改善脑卒中患者平衡功能和下肢运动功能。     

头颈部训练对偏瘫患者平衡及下肢运动功能的影响

目的:观察头颈部训练对偏瘫患者平衡及下肢运动功能的影响。方法:脑卒中偏瘫患者60例,随机分成观察组和对照组各30例。2组均进行常规康复训练,观察组增加头颈部训练,治疗前后采用徒手肌力测定(MMT)对躯干及偏瘫侧髋的屈、伸肌群进行评定,Fugl-Meyer平衡功能量表及运动功能量表(FMA)分别评定平衡及下肢运动功能。结果:治疗6周后,观察组患者躯干及患侧髋的屈、伸肌群肌力分级与对照组比较差异无统计学意义。治疗2、4及6周后,2组Fugl-Meyer平衡功能量表及FMA评分均较治疗前显著提高(P0.01),治疗2周后,观察组的Fugl-Meyer平衡功能量表评分更高于对照组(P0.05),FMA评分比较差异无统计学意义,治疗4周及6周后,观察组Fugl-Meyer平衡功能量表和FMA评分均显著高于对照组(P0.01)。结论:头颈部训练能有效提高偏瘫患者平衡及下肢运动功能。     

MOTO-med对脑卒中患者下肢运动及平衡功能恢复的作用

目的观察MOTO-med智能运动训练系统结合神经肌肉促进技术、运动再学习方法、推拿技术、关节活动范围训练、肌力训练、平衡功能训练、物理治疗、电针等综合康复训练,对脑卒中患者下肢运动功能及平衡功能改善的作用.方法脑卒中患者90例,随机分为对照组(45例)和治疗组(45例),对照组接受神经肌肉促进技术、运动再学习方法、推拿技术、关节活动范围训练、肌力训练、平衡功能训练、物理治疗、电针等综合康复训练,治疗组在综合康复训练的基础上,增加MOTO-med智能运动训练系统进行训练.分别在治疗前、治疗8周后评定两组患者下肢功能和平衡功能.结果治疗8周后,治疗组患者下肢功能和平衡功能改善较对照组患者明显,差异有统计学意义(P<0.05).结论 MOTO-med智能运动训练结合综合康复训练可改善偏瘫患者下肢功能及平衡功能.     

互动体感游戏对脑卒中患者运动和平衡功能的康复效果

目的探讨互动体感游戏对脑卒中患者下肢运动功能和平衡功能康复的有效性。方法脑卒中后下肢和平衡功能障碍患者40例分为实验组(n=20)和对照组(n=20),均接受常规康复训练治疗,实验组另加互动体感游戏Kinect。分别于干预前和干预4周后对患者进行Fugl-Meyer下肢运动功能评定(FMA)和Berg平衡量表评定。结果干预后,实验组FMA的屈肌协同运动、伸肌协同运动和坐位伴有协同运动的活动和总成绩以及Berg平衡量表成绩较对照组提高(P<0.05)。结论互动体感游戏Kinect可以进一步改善脑卒中患者的下肢运动功能和平衡功能。     

下肢康复机器人结合康复训练对脑卒中偏瘫患者下肢肌力及平衡功能的影响

目的探究下肢康复机器人结合康复训练在脑卒中偏瘫患者中的应用价值。方法选取2017年9月至2019年1月某院收治的脑卒中偏瘫患者86例,按随机数表法分为两组,各43例。对照组实施常规康复训练,观察组在对照组基础上行下肢康复机器人训练。对比两组治疗前后下肢肌力、平衡功能及下肢运动功能。结果两组治疗前腘绳肌、股四头肌评分、Fugl-Meyer运动功能量表(Fugl-Meyer assessment,FMA)、Berg平衡量表(Berg balance scale,BBS)评分比较,差异无统计学意义(P0.05);观察组治疗后腘绳肌、股四头肌评分与FMA、BBS评分均高于对照组,差异有统计学意义(P0.05)。结论脑卒中偏瘫患者实施下肢康复机器人结合康复训练能够有效提升其下肢肌力,利于恢复平衡功能与下肢运动功能。     

脑损伤患者下肢功能重建等速反馈肌力训练的研究

目的探讨脑损伤偏瘫患者下肢功能康复等速反馈肌力训练的效果。方法恢复期脑损伤偏瘫患者172例,随机分为观察组(87例),对照组(85例),两组患者常规康复训练相同,观察组增加等速反馈肌力训练,治疗前后使用Isomove等速仪检测两组患者膝伸屈生物力学指标;Fugl-Meyer量表( FMA )及改良Barthel指数评定运动功能及转移活动能力。结果经过20次治疗后,两组各生物力学指标均有改善,观察组明显优于对照组(P＜0.01);下肢运动功能、转移活动能力较对照组提高明显(P＜0.01)。结论等速反馈肌力训练对脑损伤偏瘫患者下肢功能有明显改善。     

神经网络重建治疗配合电动起立床强化训练对偏瘫患者下肢功能的影响

目的:观察神经网络重建治疗配合电动起立床强化训练对偏瘫患者下肢功能的影响。方法:将60例脑卒中患者随机等分为试验组和对照组。两组患者均接受神经科常规药物治疗和传统的康复训练,如被动活动、针灸、按摩等,而试验组进行下肢神经网络重建治疗加电动起立床训练。分别于患者治疗前、治疗后4,8周时进行下肢功能、平衡功能,日常生活能力以及患者的康复治疗依从性的评定。结果:患者的下肢功能、日常生活能力及平衡功能、康复治疗的依从性在治疗4,8周后,试验组较对照组均有明显改善(P0.05)。结论:神经网络重建治疗配合电动起立床强化下肢训练可明显改善脑卒中偏瘫患者下肢功能、自理能力、平衡功能,提高治疗的依从性。     

虚拟现实技术联合下肢康复机器人训练对缺血性脑卒中患者下肢功能及平衡能力影响的研究

目的:探讨虚拟现实技术联合下肢康复机器人训练对缺血性脑卒中患者下肢功能及平衡能力的影响。方法:收集60例缺血性脑卒中下肢功能障碍患者,随机分为对照组和观察组各30例,对照组进行常规康复训练和Lokomat下肢机器人训练,观察组在此基础上再联合虚拟现实技术,治疗前和治疗4周后分别对2组患者进行Berg平衡量表(BBS)、Fugl-Meyer下肢运动功能量表(FMA-LE)、功能性步行量表(FAC)评定。结果:治疗4周后,2组患者BBS和FMA-LE评分较治疗前均明显提高(均P<0.01),且观察组以上评分均更高于对照组(均P<0.05);2组患者FAC分级较治疗前均明显改善(均P<0.01),且观察组分级较对照组改善更显著(P<0.05)。结论:虚拟现实技术联合下肢康复机器人训练能改善缺血性脑卒中患者的下肢功能及平衡能力。     

下肢康复机器人训练对脑卒中偏瘫患者运动能力和日常生活活动能力的影响

目的探讨下肢康复机器人训练对脑卒中偏瘫患者运动能力及日常生活活动能力的影响。方法 2015年6月~2016年7月,本院40例首次脑卒中偏瘫患者随机分为对照组(n=20)和实验组(n=20)。两组均予常规康复治疗,实验组另行下肢康复机器人训练。共6周。治疗前后采用简式Fugl-Meyer下肢运动量表、Fugl-Meyer平衡量表、Holden步行功能分级和改良Barthel指数评定法对两组运动功能、平衡功能、步行能力及日常生活活动能力进行评定。结果治疗后,两组Fugl-Meyer下肢运动量表评分、Fugl-Meyer平衡量表评分、Holden步行功能分级和改良Barthel指数较治疗前明显升高(χ28.980,t3.902,P0.01),且实验组高于对照组(χ2=7.632,t2.075,P0.05)。结论下肢康复机器人训练有助于提高脑卒中偏瘫患者下肢运动功能、平衡功能、步行能力及生活自理能力。     

水中运动疗法联合电针对恢复期脑卒中患者下肢肌力和平衡功能的影响

目的:观察水中运动疗法对恢复期脑卒中下肢肌肉力量、痉挛程度及平衡功能的影响。方法:选取62例恢复期脑卒中患者,分为治疗组(水中运动疗法+常规康复治疗+电针治疗)、对照组(常规康复治疗+电针治疗),每组31例。治疗前及治疗6周后,分别采用等速肌力评定、改良Ashworth痉挛量表(MAS)、临床痉挛指数(CSI)、10m最大步行速度测定(MWS)、Berg平衡量表(BBS)对2组患者进行评定。结果:治疗后,2组患者下肢肌肉力量、MWS、BBS评分均较治疗前显著增加(均P0.05),MAS分级评分、临床痉挛指数CSI均较治疗前显著降低(P0.05);治疗后组间比较,观察组下肢肌肉力量、MWS、BBS评分均明显高于对照组(均P0.05),观察组MAS分级评分、CSI指数均低于对照组(均P0.05)。结论:水中运动疗法联合电针疗法可有效提高恢复期脑卒中患者下肢肌力,改善患者平衡功能。     

Hip external rotator exercise contributes to improving physical functions in the early stage after total hip arthroplasty using an anterolateral approach: a randomized controlled trial

Purpose: The purpose of this study was to investigate the effects of an exercise program focusing on hip external rotator muscle on physical recovery in the early post-operative period of total hip arthroplasty (THA).

Methods: Patients who underwent THA were randomized to an exercise group (n = 14) or a control group (n = 14). In exercise group, the hip external rotator exercise program was performed 5 times per week for four weeks. Outcome measures were hip pain, hip range of motion, muscle strength of lower extremity and Timed Up and Go (TUG) test.

Results: Both the hip abductor strength (effect size?=?0.60) and TUG test (effect size=??0.53) in the exercise group improved significantly after the intervention.

Conclusions: The results of the present study demonstrated that exercise program focusing on hip external rotator muscle was an effective intervention, especially in improving both hip abductor strength and walking ability in the acute post-THA stage.

• Implication for Rehabilitation

• After THA, in order to safely progress patients back to their desired activity level, there is a need to develop rehabilitation strategies to expedite and promote the recovery during the acute postoperative period.

• Exercise program focusing on hip external rotator muscle may lead to significant improvement of hip abductor muscle strength and gait ability in the acute post-THA stage.

     

Strength Training of the Nonhemiplegic Side Promotes Motor Function Recovery in Patients With Stroke: A Randomized Controlled Trial

ObjectiveTo observe the effect of strength training of the nonhemiplegic side (NHS) on balance function, mobility, and muscle strength of patients with stroke.DesignA single-blinded (evaluator) randomized controlled trial.SettingA tertiary hospital rehabilitation center.Participants139 patients with first stroke (N=139) were recruited and randomly separated into a trial (n=69) or control group (n=70).InterventionsThe control group underwent usual rehabilitation training, including step training and trunk control training in standing position. The trial group underwent strength training of NHS on the basis of usual rehabilitation training. The strength training of NHS included lower limb stepping training with resisting elastic belt and upper limb pulling elastic belt training in standing position. The training for both groups was 45 min, once a day, 5 days a week for 6 weeks.Main Outcome MeasuresBalance evaluation was done with the Berg Balance Scale (BBS); mobility assessment with the 6-minute walk test (6-MWT); activities of daily life was examined via the modified Barthel Index (MBI); muscle strengths of the biceps brachii, iliopsoas, and quadriceps were measured via the isokinetic muscle strength testing system. All assessments were performed at baseline (T0) and after intervention (T1).ResultsThe trial group performed better than control group in BBS scores (adjusted mean difference: 6.83; 95% confidence interval [CI]: 4.71-8.94) and 6-MWT (adjusted mean difference: 50.32; 95% CI: 40.58-60.05) after intervention. In terms of muscle strength of the hemiplegic side, the trial group displayed greater gains in biceps brachii, iliopsoas, and quadriceps than control group after intervention.ConclusionStrength training of the NHS can promote recovery of balance, mobility, and muscle strength of the paretic side of patients with stroke.     

悬吊运动联合姿势控制训练对亚急性期脑卒中患者运动功能的影响

目的:观察悬吊系列运动联合姿势控制训练对脑卒中偏瘫患者运动功能的影响。方法:将100例脑卒中偏瘫患者随机分成观察组和对照组各50例,2组均接受常规康复训练,包括肌力训练、神经发育疗法、本体神经肌肉促进技术、平衡训练等,观察组在此基础上增加悬吊系列运动以及姿势控制训练。分别于治疗前和治疗后,采用Sheikh评定量表、Holden步行功能分级(FAC)、改良Barthel指数(MBI)、简式Fugl-Meyer运动功能评定量表(FMA)、Berg平衡量表(BBS)进行评估。结果:治疗6周后,2组Sheikh、MBI、BBS、FAC和FMA评分均较治疗前明显提高(均P0.05),且观察组高于对照组(均P0.05)。结论:以悬吊系列运动和姿势控制训练为基础的核心肌群控制训练可促进亚急性期脑卒中偏瘫患者的运动功能的恢复。     

不对称性等速肌力训练对恢复期偏瘫患者上肢运动功能的影响

目的：研究不对称性等速肌力训练结合促通技术对脑卒中偏瘫患者上肢运动功能障碍的作用。方法：恢复期脑卒中偏瘫患者50例,随机分为A、B 2组各25例,均给予神经促通技术及有氧运动训练;A组配合不对称性等速肌力训练,即屈肘角速度为210°/s,伸肘角速度为60/°s,10个肘屈伸动作为一轮,每日3-4轮,每周3次。治疗前后使用BIODEXⅢ等速仪检测2组患者肘屈伸的各生物力学指标;Fugl-Meyer量表（FMA）及改良Ashworth痉挛量表评分评定患侧上肢运动功能及肌张力。结果：经过4周治疗后,各生物力学指标2组均有改善,A组明显优于B组（P〈0.05）;FMA积分,2组均较治疗前明显提高,A组高于B组（均P〈0.05）;改良Ashworth痉挛量表评分,2组治疗前后差异无统计学意义。结论：不对称性等速肌力训练能明显促进脑卒中偏瘫患者上肢运动功能的提高,可作为偏瘫患者上肢肌力训练的备选方法。     

Effects of Sun-style Tai Chi exercise on physical fitness and fall prevention in fall-prone older adults

AIM: This paper reports a study to determine changes in the physical fitness (knee and ankle muscle strength, balance, flexibility, and mobility), fall avoidance efficacy, and fall episodes of institutionalized older adults after participating in a 12-week Sun-style Tai Chi exercise programme. BACKGROUND: Fall prevention has a high priority in health promotion for older people because a fall is associated with serious morbidity in this population. Regular exercise is effective in fall prevention for older adults because of improvements in strength and balance. Tai Chi exercise is considered to offer great potential for health promotion and rehabilitation, particularly in the maintenance of good mental and physical condition in older people. METHODS: A quasi-experimental design with a non-equivalent control group was used. Data were collected from September 2001 to January 2002. A total of 68 fall-prone older adults with a mean age of 77.8 years participated in the study, and 29 people in the Tai Chi group and 30 controls completed the post-test measures. The Tai Chi exercise programme was provided three times a week for 12 weeks in the experimental group. Data were analysed for group differences using t-tests. RESULTS: At post-test, the experimental group showed significantly improved muscle strength in knee and ankle flexors (P < 0.001) and extensors (P < 0.01), and improved flexibility (P < 0.01) and mobility (P < 0.001) compared with the control group. There was no significant group difference in fall episodes, but the relative risk ratio for the Tai Chi exercise group compared with the control group was 0.62. The experimental group reported significantly more confidence in fall avoidance than did the control group. CONCLUSION: The findings reveal that Tai Chi exercise programmes can safely improve physical strength and reduce fall risk for fall-prone older adults in residential care facilities.     

水中平板运动对外周动脉疾病患者下肢经皮氧分压及运动能力影响的研究

目的:观察水中平板运动训练(UWTT)和普通平板运动训练(LTT)对外周动脉疾病(PAD)患者下肢经皮氧分压及运动能力的影响。方法:将58例轻、中度外周动脉疾病患者随机分为对照组(18例)、普通平板运动组(20例)及水中平板运动组(20例)。对照组只接受常规药物治疗,普通平板运动组和水中平板运动组,在常规药物治疗的基础上,分别给予普通平板运动训练和水中平板运动训练。训练频率均为每天1次,每周5天,持续12周。观察以下指数在治疗前后的评估结果:踝肱指数(ABI);PAD运动能力相关指标:运动平板测试、小腿经皮氧分压(TcPO_2)、6分钟步行距离测试(6MWDT)及行走受损问卷(WIQ);骨骼肌力量及平衡能力相关指标:肌肉力量测试、富尔顿高级平衡量表平衡评分(FAB-scale)。结果:所有测试指标,对照组治疗前后都无显著性差异(P0.05);普通平板运动及水中平板运动与本组治疗前相比,ABI、诱发跛行疼痛时间及达到跛行严重疼痛时间、TcPO_2、6MWDT、WIQ、肌肉力量、FAB量表评分值均明显提高(P0.05或P0.01);与对照组治疗后相比,普通平板运动及水中平板运动诱发跛行疼痛时间及达到跛行严重疼痛时间均明显延长(P0.001),TcPO_2、6MWDT、WIQ、肌肉力量、FAB量表评分均显著提高(P0.05或P0.01);水中平板运动与普通平板运动相比,诱发跛行疼痛时间及达到跛行严重疼痛时间、6MWDT、肌肉力量、FAB量表评分均显著升高(P0.05或P0.01)。结论:普通平板运动组与水中平板运动组均可以改善外周动脉疾病患者下肢经皮氧分压及运动能力,且水中平板运动效果优于普通平板运动。     

远程居家运动训练对新型冠状病毒肺炎出院患者运动功能的影响

目的:观察远程居家运动训练对新型冠状病毒肺炎(COVID-19)出院患者运动耐力和下肢肌肉力量的影响.方法:选取新冠患者120例,随机分为对照组(n=61)和试验组(n=59).对照组给予日常宣教,试验组使用运动康复软件进行远程居家运动训练.在治疗前、6周治疗后和24周随访评估6min步行距离(6MWD)和下肢肌肉力量...     

等速肌力训练对脑卒中偏瘫患者下肢功能恢复的影响

目的:观察等速肌力训练对偏瘫患者下肢功能恢复的影响。方法:将我院收治的40例偏瘫患者随机分为观察组和对照组各20例,对照组采用常规康复训练,包括运动治疗(神经促进疗法、平衡功能训练、等张肌力训练、桥式运动、重心转移训练、步态训练、协调与运动控制训练等)、作业治疗、传统康复疗法、物理因子治疗。观察组在常规康复训练的基础上增加偏瘫下肢屈、伸膝肌群等速肌力训练,测试及训练模式为普通等速向心/向心模式。治疗前后分别采用等速肌力测试训练仪的峰力矩值(PT)、Fugl-Meyer运动功能评分、功能独立性评分、Berg平衡功能评分及改良Ashworth肌痉挛分级(MAS)对患者下肢肌痉挛及功能情况进行分析。结果:治疗10周后,2组患者膝关节伸屈膝肌PT、Fugl-Meyer评分、Berg评分及FIM评分均较治疗前明显提高,且观察组更高于对照组(P<0.05)。治疗前后2组患者肌痉挛MAS评分组间及组内比较差异均无统计学意义。结论:等速肌力训练对偏瘫患者下肢功能恢复有明显改善作用。     

To What Extent Can Multimorbidity Be Viewed as a Determinant of Postural Control in Stroke Patients?

Spruit-van Eijk M, Zuidema SU, Buijck BI, Koopmans RT, Geurts AC. To what extent can multimorbidity be viewed as a determinant of postural control in stroke patients?ObjectiveTo investigate the determinants of postural imbalance after stroke in geriatric patients admitted for low-intensity rehabilitation in skilled nursing facilities (SNFs), particularly the role of multimorbidity.DesignCross-sectional study design.SettingFifteen SNFs.ParticipantsAll patients who were admitted for rehabilitation after stroke in one of the participating SNFs (N=378) were eligible.InterventionsNot applicable.Main Outcome MeasuresThe Berg Balance Scale (BBS) was selected as a measure of standing balance and the Functional Ambulation Categories (FAC) as a measure of walking balance.ResultsMultimorbidity was present in 34% of the patients. The patients with multimorbidity differed from the patients without multimorbidity with respect to age, proprioception, and vibration sense, but not for any of the cognitive tests, muscle strength, or sitting balance. Patients with multimorbidity had, on average, lower scores on both outcome measures. In linear regression analyses, both the BBS and FAC were best explained by multimorbidity, muscle strength, and the interaction between muscle strength and static sitting balance (overall explained variance 66% and 67%, respectively), while proprioception added only to the variance of the FAC.ConclusionsMultimorbidity was independently related to postural imbalance after stroke in patients admitted for rehabilitation in SNFs. Muscle strength and the interaction of muscle strength with static sitting balance were important determinants of both standing and walking balance, indicating these factors as essential targets for rehabilitation.