上肢康复机器人治疗对脑瘫痉挛型偏瘫患儿上肢运动功能恢复的影响

目的：观察上肢康复机器人治疗对脑瘫痉挛型偏瘫患儿患侧上肢运动功能恢复的影响，探索机器人康复训练能否替代人工训练。方法：将脑瘫痉挛型偏瘫患儿49例按照随机数字表法分为对照组（ｎ＝25）和观察组（ｎ＝24），对照组每天进行常规康复训练２次；观察组进行常规康复训练１次、上肢机器人训练１次，2组均训练８周。治疗前后分别采用脑瘫儿童手功能分级（ＭＡＣＳ）、墨尔本单侧上肢功能评定量表（ＭＵＵＬ）进行评定，测量患侧肘关节、肩关节水平位主动活动度（ＲＯＭ）。结果：与训练前比较，训练后２组ＭＵＵＬ评分均有显著增高（Ｐ＜０.０１），２组间比较差异无统计学意义；训练后２组ＭＡＣＳ评分均较训练前有显著降低（Ｐ＜０.０１），２组间比较差异无统计学意义；训练后２组肩关节水平内收ＲＯＭ均较训练前有显著增加（Ｐ＜０.０１），２组间比较差异无统计学意义；训练后２组肩关节水平外展及肘关节ＲＯＭ较训练前均有显著增加（Ｐ＜０.０１），观察组更高于对照组（Ｐ＜０.０５）。结论：上肢康复机器人结合常规康复训练能促进脑瘫痉挛型偏瘫患儿上肢运动功能的恢复，上肢康复机器人训练效果与人工效果相当，在某些方面要优于常规人工训练。

Effects of upper limb rehabilitation intelligent robot on upper limb motor function in children with cerebral palsy spastic hemiplegia

Objective: To observe the effect of upper limb rehabilitation robot on the recovery of motor function of the affected side of cerebral palsy spastic hemiplegia in children, and whether robot rehabilitation training can replace manual training. Methods: A total of 49 children with cerebral palsy spastic hemiplegia were divided into control group (n=25) and observation group (n=24). The control group received routine rehabilitation training twice a day. The observation group received routine rehabilitation training once and upper limb robot training once for a total of 8 weeks. The Manual Ability Classifacation System (MACS) was adopted for children with cerebral palsy before and after treatment. Melbourne assessment of unilateral upper limb function (MUUL), the range of motion (ROM) of elbow joint and shoulder joint were measured. Results: After training, the MUUL score in the two groups was significantly increased (P<0.001), but there was no significant difference between the two groups. MACS scores in both groups were significantly decreased (P<0.001), but there was no significant difference between the two groups. The elbow joint ROM was significantly increased in both groups (P<0.001), and that in the observation group was better than in the control group (P<0.05). The horizontal adduction ROM of shoulder joint was significantly increased in both groups (P<0.001), but there was no significant difference between the two groups. The horizontal abduction ROM of shoulder joint was significantly increased in both groups (P<0.001), and that in the observation group was better than in the control group (P<0.05). Conclusion: Upper limb rehabilitation robot combined with routine rehabilitation training can promote the recovery of upper limb motor function in children with cerebral palsy spastic hemiplegia. The effect of upper limb rehabilitation robot training is equivalent to that of manual training, and in some aspects it is better than conventional manual training.