本文選題：上肢康復(fù)機(jī)器人 + 腦卒中　； 參考：《廣州醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:探討上肢康復(fù)機(jī)器人輔助虛擬現(xiàn)實(shí)技術(shù)對(duì)腦卒中恢復(fù)期偏癱上肢運(yùn)動(dòng)功能和活動(dòng)能力的影響,以及上肢運(yùn)動(dòng)功能與活動(dòng)能力康復(fù)的相關(guān)性。方法:選取符合入組標(biāo)準(zhǔn)的腦卒中后恢復(fù)期偏癱上肢功能障礙患者40例,使用隨機(jī)數(shù)字法分為試驗(yàn)組和對(duì)照組,兩組患者均接受相同的基礎(chǔ)治療,包括藥物治療和運(yùn)動(dòng)治療。試驗(yàn)組給予上肢康復(fù)機(jī)器人輔助虛擬游戲訓(xùn)練,對(duì)照組給予常規(guī)作業(yè)治療。兩組患者治療周期均為2周,每天1次,共12次,每次持續(xù)30分鐘。兩組患者治療前后均進(jìn)行運(yùn)動(dòng)功能和活動(dòng)能力的評(píng)估,其中運(yùn)動(dòng)功能評(píng)估包括上肢和手的Brunnstrom分期、Fugl-Meyer評(píng)分,活動(dòng)能力評(píng)估包括改良巴氏指數(shù)(MBI)、動(dòng)作活動(dòng)記錄量表(MAL)、上肢功能指數(shù)(UEFI)。結(jié)果:1.試驗(yàn)組治療后上肢和手的Brunnstrom分期、FMA評(píng)分(上肢、腕、手和總分)均較治療前明顯提高(P0.05)。對(duì)照組治療后手的Brunnstrom分期、FMA評(píng)分(上肢、手和總分)均較治療前明顯提高(P0.05)。上肢Brunnstrom分期、FMA腕關(guān)節(jié)評(píng)分比治療前提高,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。試驗(yàn)組治療前后FMA上肢評(píng)分和總分改善程度優(yōu)于對(duì)照組,且差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。2.兩組治療后改良巴氏指數(shù)(MBI評(píng)分)、上肢功能指數(shù)(UEFI)及動(dòng)作活動(dòng)記錄量表評(píng)分(包括患側(cè)肢體使用頻率和運(yùn)動(dòng)質(zhì)量)較治療前均顯著性提高(P0.05)。試驗(yàn)組治療前后患側(cè)肢體使用頻率和運(yùn)動(dòng)質(zhì)量評(píng)分改善程度均優(yōu)于對(duì)照組,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。3.上肢和手的運(yùn)動(dòng)功能評(píng)分與活動(dòng)能力評(píng)分成呈正相關(guān)性。其中患側(cè)肢體使用頻率與FMA評(píng)分(上肢、腕、手和總分)呈低度相關(guān)關(guān)系,運(yùn)動(dòng)質(zhì)量與FMA評(píng)分(上肢、手和總分)呈顯著相關(guān)關(guān)系,與FMA腕關(guān)節(jié)評(píng)分呈低度相關(guān)。上肢功能指數(shù)(UEFI)與FMA評(píng)分(上肢、手和總分)呈顯著相關(guān)關(guān)系,與FMA腕關(guān)節(jié)評(píng)分呈低度相關(guān)關(guān)系。日常生活活動(dòng)能力(MBI評(píng)分)與FMA手評(píng)分呈低度相關(guān)關(guān)系,與FMA上肢、腕關(guān)節(jié)評(píng)分及總分呈弱相關(guān)關(guān)系。4.兩組患者治療后1個(gè)月隨訪的MBI評(píng)分均較治療結(jié)束時(shí)提高,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。試驗(yàn)組MBI評(píng)分改善程度優(yōu)于對(duì)照組,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)結(jié)論:1.上肢康復(fù)機(jī)器人輔助虛擬現(xiàn)實(shí)技術(shù)訓(xùn)練和常規(guī)作業(yè)治療均可以改善腦卒中恢復(fù)期偏癱上肢和手運(yùn)動(dòng)功能和活動(dòng)能力。2.上肢康復(fù)機(jī)器人輔助虛擬現(xiàn)實(shí)技術(shù)訓(xùn)練對(duì)腦卒中恢復(fù)期偏癱上肢和手的運(yùn)動(dòng)功能及使用頻率、運(yùn)動(dòng)質(zhì)量的療效優(yōu)于常規(guī)作業(yè)治療,且對(duì)日常生活活動(dòng)能力有一定遠(yuǎn)期療效。3.康復(fù)訓(xùn)練可促進(jìn)腦卒中恢復(fù)期偏癱上肢和手功能的運(yùn)動(dòng)功能和活動(dòng)能力的改善,且兩者的康復(fù)存在顯著正相關(guān)關(guān)系。
[Abstract]:Objective: to investigate the effect of robot assisted virtual reality (VR) technique on upper limb motor function and motor ability of hemiplegic patients with cerebral apoplexy and the correlation between upper limb motor function and rehabilitation of upper limb movement ability. Methods: forty patients with hemiplegic upper limb dysfunction in convalescence after stroke were selected and randomly divided into two groups: the experimental group and the control group. The two groups received the same basic treatment, including drug therapy and exercise therapy. The experimental group was given virtual game training assisted by upper limb rehabilitation robot, and the control group was treated with routine operation. Two groups of patients were treated for 2 weeks, once a day, a total of 12 times, each time for 30 minutes. Motor function and motor ability were evaluated before and after treatment in both groups. Motor function assessment included Brunnstrom stage and Fugl-Meyer score of upper limbs and hands. The evaluation of motor ability included modified pasteurian index (MBI), motor activity record scale (MALL) and upper limb function index (UEFI). The result is 1: 1. The Brunnstrom scores (upper limb, wrist, hand and total score) of upper limbs and hands in the experimental group were significantly higher than those before treatment (P 0.05). In the control group, the Brunnstrom stage and total score (upper limb, hand and total score) of the hand after treatment were significantly higher than those before treatment (P 0.05). The upper limb Brunnstrom stage and wrist joint score were higher than those before treatment, and the difference was not statistically significant (P 0.05). The improvement of FMA upper limb score and total score in the trial group was better than that in the control group before and after treatment, and the difference was statistically significant. After treatment, the modified pasteurian index (MBI), upper limb function index (UEFI) and motion record scale (including the frequency of limb use and motor quality of the affected side) were significantly higher than those before treatment (P 0.05). The improvement of limb use frequency and motor quality score in the experimental group was better than that in the control group before and after treatment, and the difference was statistically significant (P 0.05). The motor function scores of upper limbs and hands were positively correlated with motor ability scores. There was a low correlation between the frequency of limb use and FMA score (upper limb, wrist, hand and total score), a significant correlation between motor quality and FMA score (upper limb, hand and total score), and a low correlation with FMA wrist score. There was a significant correlation between UEFI and FMA score (upper limb, hand and total score), and a low correlation between UEFI and FMA wrist score. The activity of daily living (ADL) score showed a low correlation with FMA hand score, and a weak correlation with FMA upper limb, wrist joint score and total score. The MBI scores of the two groups were significantly higher than those at the end of the treatment after one month follow-up (P 0.05). The improvement of MBI score in the test group was better than that in the control group (P 0.05). The training of virtual reality technique and routine work therapy can improve the upper limb and hand motor function and movement ability of hemiplegia in convalescent stage of stroke. The upper limb rehabilitation robot assisted virtual reality technique training for upper limb and hand motor function and use frequency in convalescent stage of stroke is superior to routine operation treatment, and has a certain long-term effect on daily living ability. 3. The effect of virtual reality technology training on hemiplegic upper limb and hand in convalescent stage of stroke is better than that of routine operation. Rehabilitation training can promote the improvement of motor function and movement ability of upper limb and hand function of hemiplegia in convalescent stage of stroke, and there is a significant positive correlation between them.
【學(xué)位授予單位】：廣州醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：TP242;TP391.9;R743.3

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