上肢康复机器人联合等速肌力训练对脑卒中恢复期偏瘫患者的康复效果研究

摘要 目的：探讨等速肌力训练联合上肢康复机器人在脑卒中恢复期偏瘫患者中的应用效果。方法：根据随机数字表法，将2020年1月-2022年12月期间合肥市第二人民医院收治的136例脑卒中恢复期偏瘫患者分为对照组（n=68，等速肌力训练）与观察组（n=68，等速肌力训练联合上肢康复机器人干预）。两组均干预3周，观察两组Fugl-Meyer上肢运动功能量表（FMA-UL）评分、改良Barthel指数（MBI）评分、偏瘫Brunnstrom分级、表面肌电图相关指标和生活质量评分变化情况。结果：观察组干预3周后FMA-UL、MBI评分高于对照组（P<0.05）。观察组干预3周后IV级患者例数多于对照组（P<0.05）。观察组干预3周后肱二头肌、肱三头肌、三角肌前束、三角肌中束的均方根值（RMS）和积分肌电值（iEMG）高于对照组（P<0.05）。观察组干预3周后生理职能、躯体疼痛、生理功能、总体健康、精神健康、活力、情感职能、社会功能各维度评分高于对照组（P<0.05）。结论：脑卒中恢复期偏瘫患者经等速肌力训练、上肢康复机器人联合干预，可促进偏瘫上肢肌肉激活和运动单位募集同步化，改善上肢肌力，提高患者的生活质量。

Study on the Rehabilitation Effect of Upper Limb Rehabilitation Robot Combined with Isokinetic Muscle Strength Training on Hemiplegic Patients During Stroke Recovery

ABSTRACT Objective: To explore the application effect of isokinetic muscle strength training combined with upper limb rehabilitation robot on hemiplegic patients during stroke recovery. Methods: According to random number table method, 136 cases of hemiplegic patients during stroke recovery who were admitted to the Second People''s Hospital of Hefei from January 2020 to December 2022 were divided into control group (n=68, isokinetic muscle strength training) and observation group (n=68, isokinetic muscle strength training combined with upper limb rehabilitation robot intervention). Intervention for 3 weeks in both groups, and the changes of Fugl-Meyer Upper Limb Motor Function Scale (FMA-UL) score, modified Barthel index (MBI) score, Brunnstrom grade of hemiplegia, surface electromyography related indexes and quality of life score were observed in both groups. Results: 3 weeks after intervention, FMA-UL and MBI scores in the observation group were higher than those in the control group(P<0.05). 3 weeks after intervention, the number of grade IV patients in the observation group was more than that in the control group(P<0.05). 3 weeks after intervention, the root mean square (RMS) and integrated electromyography (iEMG) values of bicipital muscle of arm, triceps muscle of arm, anterior deltoid and middle deltoid fascicles in observation group were higher than those in control group(P<0.05). 3 weeks after intervention, the scores of physiological function, physical pain, physiological function, general health, mental health, vitality, emotional function and social function in the observation group were higher than those in the control group(P<0.05). Conclusion: The combined intervention of isokinetic muscle strength training and upper limb rehabilitation robot on hemiplegic patients during stroke recovery can promote muscle activation in the upper limb of hemiplegia and the synchronization of motor unit recruitment, improve upper limb muscle strength, and improve the quality of life of patients.