本文選題：卒中 + 肩關(guān)節(jié)半脫位��； 參考：《中國(guó)腦血管病雜志》2016年06期

【摘要】：目的探討上肢康復(fù)機(jī)器人輔助訓(xùn)練對(duì)卒中后上肢痙攣伴肩關(guān)節(jié)半脫位患者運(yùn)動(dòng)功能的康復(fù)作用。方法回顧性納入2015年3月至12月卒中后上肢痙攣伴肩關(guān)節(jié)半脫位的患者40例,采用數(shù)字表法將患者隨機(jī)分為機(jī)器人組和對(duì)照組各20例。對(duì)照組患者采用常規(guī)康復(fù)治療,40 min/次。機(jī)器人組在常規(guī)康復(fù)的基礎(chǔ)上增加上肢康復(fù)機(jī)器人訓(xùn)練,30 min/次。兩組患者訓(xùn)練均為2次/d,10次/周。均于治療前及治療后6周進(jìn)行運(yùn)動(dòng)功能及日常生活能力評(píng)定。通過(guò)測(cè)量患者坐位患肩肩峰至肱骨頭間距(AHI)評(píng)定肩關(guān)節(jié)半脫位距離;采用改良Ashworth量表(MAS)評(píng)定痙攣程度;采用簡(jiǎn)式Fugl-Meyer運(yùn)動(dòng)功能評(píng)分(FMA)評(píng)價(jià)上肢運(yùn)動(dòng)功能;改良Barthel指數(shù)(MBI)量表評(píng)價(jià)日常生活能力。結(jié)果治療前兩組患者基線指標(biāo)比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。治療后6周,機(jī)器人組的AHI值從治療前的(22.7±1.2)mm降至(10.6±1.2)mm;MAS評(píng)分從治療前的(2.01±0.28)分降至(0.59±0.23)分,差異均有統(tǒng)計(jì)學(xué)意義(均P0.05);FMA從治療前的(30±9)分升至(54±8)分;MBI從治療前的(44±8)分升至(83±10)分;差異均有統(tǒng)計(jì)學(xué)意義(均P0.05)。治療后機(jī)器人組的AHI值及MAS、FMA和MBI評(píng)分明顯優(yōu)于對(duì)照組(t值分別為-4.009、-6.846,2.938和5.548,均P0.05)。結(jié)論上肢康復(fù)機(jī)器人輔助訓(xùn)練能夠改善卒中后患者的上肢痙攣伴肩關(guān)節(jié)半脫位狀態(tài),促進(jìn)患者運(yùn)動(dòng)功能和日常生活能力的提高。
[Abstract]:Objective to investigate the rehabilitation effect of upper limb rehabilitation robot assisted training on motor function of patients with spasm of upper extremity and subluxation of shoulder joint after stroke. Methods Forty patients with upper limb spasm with shoulder subluxation after stroke from March to December 2015 were enrolled retrospectively. The patients were randomly divided into two groups: the robot group and the control group. Patients in the control group were treated with routine rehabilitation for 40 min/. On the basis of routine rehabilitation, the robot group increased the training time of upper limb rehabilitation robot for 30 min/. The two groups of patients were trained twice / d 10 times a week. Motor function and ADL were evaluated before and 6 weeks after treatment. The distance of shoulder subluxation was assessed by measuring the distance between shoulder acromium and humerus head in sitting position, the degree of spasm was assessed by modified Ashworth scale, and the motor function of upper extremity was evaluated by simple Fugl-Meyer motor function score. The activity of daily living (ADL) was evaluated by modified Barthel index. Results there was no significant difference in baseline indexes between the two groups before treatment (P 0.05). Six weeks after treatment, the AHI score of the robot group decreased from 22.7 鹵1.2)mm to 10.6 鹵1.2mm Mas from 2.01 鹵0.28 to 0.59 鹵0.23, and the difference was statistically significant (all P0.05FMAs increased from 30 鹵9 to 54 鹵8) and the score of MBI increased from 44 鹵8 to 83 鹵10). The difference was statistically significant (P 0.05). After treatment, the AHI, MASM and MBI scores in the robot group were significantly higher than those in the control group (-4.009 ~ 6.846 鹵2.938 and 5.548, respectively, P < 0.05). Conclusion the upper limb rehabilitation robot assisted training can improve the upper limb spasm with shoulder subluxation after stroke and promote the improvement of patients' motor function and daily living ability.
【作者單位】： 首都醫(yī)科大學(xué)宣武醫(yī)院康復(fù)醫(yī)學(xué)科;
【分類號(hào)】：R743.3;R684.7

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