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目的:探讨可穿戴设备uCare对脑卒中患者社区康复的指导和监测作用,为临床应用提供试验基础。方法:39例脑卒中患者随机分为试验组和对照组。2组患者均接受常规社区康复指导,并根据心肺运动试验结果制定社区康复运动处方。试验组佩戴可穿戴设备uCare进行运动指导和监测,对照组仅进行口头指导下的运动。分别于入选时和4周末进行ICF核心组合评估(通用组合、功能障碍组合、脑卒中简要组合)、Motricity指数、6min步行试验、最大耗氧量评估。结果:①与入组时相比,试验组ICF核心评估组合、6min步行试验、最大耗氧量均有显著改善(P0.05);Motricity指数数值虽有提升,但差异无显著性意义(P0.05);对照组各数值虽有改善,但差异无显著性意义(P0.05)。②入组时两组间比较,差异无显著性意义(P0.05);4周后两组间比较,试验组6min步行试验结果优于对照组(P0.05)。结论:使用可穿戴设备uCare,可有效改善社区脑卒中患者的ICF指标和运动功能。 相似文献
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目的 探讨可穿戴机器人改善脑卒中患者平衡及步行功能的临床疗效。 方法 将符合条件的脑卒中患者80例按随机数字表法分为观察组和对照组,每组40例。对照组予以常规康复联合可穿戴机器人无助力治疗,观察组予以常规康复联合可穿戴机器人助力治疗,可穿戴机器人治疗为1次/日,每次20 min,6次/周。分别于治疗前和治疗4周后(治疗后),采用Berg平衡量表(BBS)评分和功能性步行分级(FAC)评分对2组患者的平衡能力及步行能力进行评估,用Prokin平衡仪测定2组患者的运动轨迹长度和面积,利用可穿戴机器人系统测定患侧步长和步速。 结果 治疗后,2组患者的BBS评分、FAC评分、运动轨迹长度、运动轨迹面积以及步长和步速等各项指标均较组内治疗前显著改善(P<0.05);观察组治疗后的BBS评分、FAC评分、运动轨迹长度、运动轨迹面积、患侧步长和患侧步速分别为(43.31±2.21)分、(4.63±0.50)分、(372.51±95.41)mm、(625.31±127.97)mm2、(0.54±0.04)m、(0.70±0.05)m/s,明显改善优于对照组治疗后[(39.63±2.49)分、(3.97±0.28)分、(455.18±104.50)mm、(763.37±132.91)mm2、(0.41±0.02)m、(0.48±0.03)m/s],且组间差异均有统计学意义(P<0.05)。 结论 常规康复联合可穿戴机器人助力治疗可显著改善脑卒中患者平衡及步行功能,且较单独使用常规康复治疗的疗效好。 相似文献
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脑卒中是导致成年人残疾的主要病因之一。对于因神经元受损引发功能障碍的脑卒中患者,可穿戴设备能为其提供密集、重复、有任务导向性的康复训练与运动反馈,进而促进神经功能与运动功能的恢复。本文从康复评估与康复治疗两个方面,对可穿戴设备在脑卒中康复中的应用研究进行综述,并对其目前存在的局限性及今后的发展方向进行分析与探讨,旨在为相关研究与开发提供参考。 相似文献
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目的:研究可穿戴式智能足底压力视觉反馈技术对脑卒中患者平衡功能的影响,并探讨此技术在临床平衡功能训练中的应用方式和价值。方法:选择病程为8个月内的脑卒中患者30例,随机分配到试验组和对照组,每组15例。对照组接受常规平衡训练,试验组在可穿戴式智能足底压力视觉反馈技术配合下进行平衡训练,每次30min,每周5次,共训练4周。比较训练前及训练4周后两组患者的平衡功能评分,包括Berg平衡量表(BBS),"起立—行走"计时测试(TUG)和采用可穿戴式智能足底压力视觉反馈鞋垫记录的睁眼和闭眼静态平衡率,以评估训练的有效性和对照组与试验组间训练效果的差异。结果:训练前两组患者的一般资料、BBS及TUG评分和静态平衡率均无显著性差异(P0.05);训练后,试验组和对照组患者各观察指标与训练前相比均有显著改善(P0.05)。试验组的训练后与训练前各平衡功能评分差值与对照组相较更大,且有显著性差异(P0.05)。结论:应用可穿戴式智能足底压力视觉反馈技术进行平衡功能训练可以改善偏瘫患者的平衡功能,且较常规方法更有效。 相似文献
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目的探讨上肢动作研究量表(ARAT)在脑卒中患者中的评价者间信度、评价者内信度和内在一致性。方法由两位评价者各自独立的对30例慢性脑卒中患者进行ARAT的评价。检验ARAT的评价者间信度、评价者内信度和内在一致性。结果ARAT的评价者间信度和评价者内信度ICC值分别为0.992和0.987。内在一致性分析结果Cronbach'sα系数为0.936。结论ARAT在脑卒中患者中具有良好的评价者间信度、评价者内信度和内在一致性。 相似文献
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目的 探讨动作观察配合作业治疗对脑卒中患者上肢功能及日常生活能力的影响。 方法 将42例脑卒中偏瘫患者按照随机数字表法分为实验组和对照组,每组21例。所有患者均接受常规康复治疗,实验组在此基础上增加动作观察配合作业治疗,对照组增加常规作业治疗。在治疗前和治疗8周后(治疗后),采用Fugl-Meyer运动功能量表上肢部分(FMA-UE)、香港版偏瘫上肢功能测试(FTHUE-HK)和改良Barthel指数(MBI)评价患者的上肢运动功能和日常生活能力。 结果 治疗前,2组患者FMA-UE、FTHUE-HK、MBI结果比较,差异无统计学意义(P>0.05)。与组内治疗前比较,2组患者FMA-UE、FTHUE-HK、MBI均有所改善(P<0.05)。与对照组治疗后比较,实验组FMA-UE[(42.81±13.59)分]、FTHUE-HK[(5.00±1.38)级]、MBI[(73.86±18.83)分]较为优异(P<0.05)。 结论 动作观察配合作业治疗能更好地改善脑卒中患者的上肢功能及日常生活能力。 相似文献
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目的探讨上肢康复机器人训练对亚急性脑卒中患者认知功能、上肢运动功能和日常生活能力的影响。方法2019年9月至2020年9月,温州医科大学附属第一医院康复科亚急性期脑卒中并发认知障碍的偏瘫患者65例随机分为对照组(n=32,脱落2例)和试验组(n=33,脱落3例)。两组均接受常规作业治疗,对照组接受常规认知训练,试验组接受上肢康复机器人训练,共4周。治疗前后采用蒙特利尔认知评估(MoCA)、简易精神状态检查(MMSE)、Fugl-Meyer评定量表上肢部分(FMA-UE)和改良Barthel指数(MBI)进行评定。结果治疗后,两组MoCA、MMSE、FMA-UE和MBI评分均显著改善(t>22.11,Z>4.79,P<0.001),试验组MoCA总分及部分维度分,MMSE总分及部分维度分,FMA-UE总分及手臂分,MBI评分均优于对照组(t>2.06,Z>3.19,P<0.05)。结论上肢康复机器人训练有助于改善亚急性脑卒中患者的认知功能、上肢运动功能和日常生活活动能力。 相似文献
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目的:观察上肢康复训练系统对脑卒中患者上肢功能康复的临床疗效。方法:脑卒中偏瘫上肢功能障碍患者42例,分为观察组22例和对照组20例。2组患者均接受常规药物治疗和康复训练。观察组在此基础上加用Rejoyce上肢康复训练。治疗前后采用Fugl-Meyer量表上肢部分(FMA-UE)、Rejoyce手功能测试(RAHFT)和功能独立性评定(FIM)评定2组疗效。结果:治疗4周后,2组FMA-UE、RAHFT及FIM评分治疗前后及组间比较均差异无统计学意义;治疗8周后,2组FMA-UE、RAHFT及FIM评分均较治疗前及治疗4周时明显提高(P0.05,0.01),且观察组更高于对照组(P0.05)。结论:Rejoyce上肢康复训练结合常规康复作业治疗能更好地改善脑卒中恢复期患者偏瘫上肢及手的功能,更有效地提高患者日常生活活动能力。 相似文献
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摘要
目的:本研究探讨上肢机器人分离运动训练改善脑卒中患者上肢运动功能的疗效,并通过分析其经颅磁刺激运动诱发电位(transcranial magnetic stimulation motor-evoked potential, MEP),进一步探讨其相关机制。
方法:招募符合条件的脑卒中患者作为研究对象并随机分为试验组(n=21)和对照组(n=23),试验组进行固定轨迹(肘关节屈曲伸直、肩关节内收外展的分离运动)的上肢机器人训练,对照组进行随意运动轨迹(够取物品的复合动作)的上肢机器人训练。两组的机器人训练均1次/天,20min/次,5次/周,连续3周;对两组患者分别进行Fugl-Meyer上肢运动功能评分(Fugl-Meyer assessment of upper extremity,FMA-UE)和改良Barthel指数(modified Barthel index,MBI)的评定。检测两组患者治疗前后MEP的潜伏期以及中枢运动传导时间(central motor conduction time,CMCT)。
结果:治疗3周后试验组患者的FMA-UE、MBI评分及MEP与治疗前比较均有改善(P<0.05),对照组患者的FMA-UE、MBI评分、MEP与治疗前比无明显差异(P>0.05);治疗3周后组间比较,两组患者的FMA-UE、MBI评分及MEP无明显差异(P>0.05)。
结论:上肢机器人的分离运动训练能改善脑卒中患者上肢运动功能,提高脑卒中患者日常生活自理能力,这可能与增强了脑卒中患者的脑功能重塑有关。 相似文献
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OBJECTIVE: To determine the effectiveness of the Bobath concept at reducing upper limb impairments, activity limitations and participation restrictions after stroke. METHODS: Electronic databases were searched to identify relevant trials published between 1966 and 2003. Two reviewers independently assessed articles for the following inclusion criteria: population of adults with upper limb disability after stroke; stated use of the Bobath concept aimed at improving upper limb disability in isolation from other approaches; outcomes reflecting changes in upper limb impairment, activity limitation or participation restriction. RESULTS: Of the 688 articles initially identified, eight met the inclusion criteria. Five were randomized controlled trials, one used a single-group crossover design and two were single-case design studies. Five studies measured impairments including shoulder pain, tone, muscle strength and motor control. The Bobath concept was found to reduce shoulder pain better than cryotherapy, and to reduce tone compared to no intervention and compared to proprioceptive neuromuscular facilitation (PNF). However, no difference was detected for changes in tone between the Bobath concept and a functional approach. Differences did not reach significance for measures of muscle strength and motor control. Six studies measured activity limitations, none of these found the Bobath concept was superior to other therapy approaches. Two studies measured changes in participation restriction and both found equivocal results. CONCLUSIONS: Comparisons of the Bobath concept with other approaches do not demonstrate superiority of one approach over the other at improving upper limb impairment, activity or participation. However, study limitations relating to methodological quality, the outcome measures used and contextual factors investigated limit the ability to draw conclusions. Future research should use sensitive upper limb measures, trained Bobath therapists and homogeneous samples to identify the influence of patient factors on the response to therapy approaches. 相似文献
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Masiero S Celia A Rosati G Armani M 《Archives of physical medicine and rehabilitation》2007,88(2):142-149
OBJECTIVE: To investigate whether early therapy with a novel robotic device can reduce motor impairment and enhance functional recovery of poststroke patients with hemiparetic and hemiplegic upper limb. DESIGN: A single-blind randomized controlled trial, with an 8-month follow-up. SETTING: Neurologic department and rehabilitation hospital. PARTICIPANTS: Thirty-five patients with acute (< or =1 wk of onset), unilateral, ischemic embolic, or thrombotic stroke. INTERVENTIONS: Patients of both groups received the same dose and length per day of standard poststroke multidisciplinary rehabilitation. Patients were randomly assigned to 2 groups. The experimental group (n=17) received additional early sensorimotor robotic training, 4 hours a week for 5 weeks; the control group (n=18) was exposed to the robotic device, 30 minutes a week, twice a week, but the exercises were performed with the unimpaired upper limb. Training by robot consisted of peripheral manipulation of the shoulder and elbow of the impaired limb, correlated with visual stimuli. MAIN OUTCOME MEASURES: The Fugl-Meyer Assessment (FMA) of upper-extremity function (shoulder/elbow and coordination and wrist/hand subsections) to measure each trained limb segment; the Medical Research Council (MRC) score to measure the strength of muscle force during 3 actions: shoulder abduction (MRC deltoid), elbow flexion (MRC biceps), and wrist flexion (MRC wrist flexors); the FIM instrument and its motor component; and the Trunk Control Test (TCT) and Modified Ashworth Scale (MAS). RESULTS: Compared with the patients in the control group, the experimental group showed significant gains in motor impairment and functional recovery of the upper limb after robot therapy, as measured by the MRC deltoid (P< or =.05) and biceps (P<.05) scores, the FMA for the proximal upper arm (P<.05), the FIM instrument (P<.05), and the FIM motor score (P<.01); these gains were also sustained at the 3- and 8-month follow-up. The FMA and MRC wrist flexor test findings did not differ statistically either at the end of training or at the follow-up sessions. We found no significant differences in MAS and TCT in either group in any of the evaluations. No adverse effects occurred and the robotic approach was very well accepted. CONCLUSIONS: Patients who received robotic therapy in addition to conventional therapy showed greater reductions in motor impairment and improvements in functional abilities. Robotic therapy may therefore effectively complement standard rehabilitation from the start, by providing therapeutic support for patients with poststroke plegic and paretic upper limb. 相似文献
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目的:基于表面肌电(sEMG)观察蝶形浴对脑卒中偏瘫患者上肢痉挛的影响。方法:采用随机数字表法将60例脑卒中偏瘫患者分为观察组和对照组各30例。2组患者均给予常规的康复治疗,观察组患者在此基础上进行蝶形浴治疗。分别于治疗前、治疗4周后采用表面肌电图记录肘关节屈曲最大等长收缩时肱二头肌与肱三头肌积分肌电值(IEMG)、改良Ashworth量表(MAS)来评估2组患者患侧肘关节及腕关节的肌张力大小,采用简易Fugl-Meyer上肢运动功能评分(FMA-U)评估2组患者的上肢运动功能。结果:治疗4周后,2组患者肘关节屈曲最大等长收缩时肱二头肌IEMG均较治疗前明显降低(均P0.05),且观察组更低于对照组(P0.05);肱三头肌IEMG均较治疗前明显增高(均P0.05),且观察组更高于对照组(P0.05);2组患侧肘、腕关节屈肌MAS评分均较治疗前下降(均P0.05),且观察组明显低于对照组(P0.05);2组患侧FMA-U评分均较治疗前明显提高(P0.05),且观察组明显高于对照组(P0.05)。结论:蝶形浴疗法可以有效地缓解脑卒中偏瘫患者的上肢痉挛,减轻因痉挛导致的上肢运动功能障碍,值得在临床推广应用。 相似文献