發(fā)布時(shí)間：2018-06-06 09:17

  本文選題：機(jī)器人 + 缺血性腦卒中��； 參考：《河北聯(lián)合大學(xué)》2014年碩士論文

【摘要】：目的探討Lokomat全自動(dòng)機(jī)器人步態(tài)訓(xùn)練與評(píng)定系統(tǒng)（以下簡(jiǎn)稱Lokomat機(jī)器人）改善缺血性腦卒中偏癱患者下肢功能的影響，，為缺血性腦卒中后偏癱患者提供一種安全有效的康復(fù)訓(xùn)練方法。 方法1收集符合納入標(biāo)準(zhǔn)的2012年3月至2013年5月河北聯(lián)合大學(xué)附屬醫(yī)院神經(jīng)內(nèi)科及康復(fù)科住院病人，共計(jì)40例。2依據(jù)年齡、既往病史、病情作為配對(duì)因素，進(jìn)行兩兩配對(duì)，將對(duì)子內(nèi)個(gè)體分為干預(yù)組和對(duì)照組，每組20例。干預(yù)組：進(jìn)行Lokomat機(jī)器人康復(fù)訓(xùn)練，對(duì)照組：進(jìn)行傳統(tǒng)康復(fù)訓(xùn)練。3分別對(duì)干預(yù)組及對(duì)照組患者于訓(xùn)練前、訓(xùn)練后6w、12w進(jìn)行神經(jīng)功能缺損評(píng)分（下肢）（NIHSS）、髖膝關(guān)節(jié)活動(dòng)度評(píng)定、Fugl-Meyer運(yùn)動(dòng)功能量表（FMA）評(píng)分、功能性步行量表（FAC）評(píng)分、Berg平衡量表評(píng)分、Barthel指數(shù)評(píng)分及步態(tài)參數(shù)評(píng)定，并將上述評(píng)定結(jié)果進(jìn)行統(tǒng)計(jì)學(xué)分析。 結(jié)果1訓(xùn)練前兩組患者神經(jīng)功能缺損評(píng)分（下肢）（NIHSS）、髖膝關(guān)節(jié)活動(dòng)度、Fugl-Meyer運(yùn)動(dòng)功能量表（FMA）評(píng)分、功能性步行量表（FAC）評(píng)分、Berg平衡量表評(píng)分、 Barthel指數(shù)評(píng)分及步態(tài)參數(shù)比較均無(wú)統(tǒng)計(jì)學(xué)差異（P0.05）。2訓(xùn)練后組內(nèi)比較：上述評(píng)定結(jié)果在訓(xùn)練6w、訓(xùn)練12w均較訓(xùn)練前明顯改善，差異有統(tǒng)計(jì)學(xué)意義（P0.05），且訓(xùn)練12w較訓(xùn)練6w明顯改善，差異有統(tǒng)計(jì)學(xué)意義（P0.05）。3兩組患者訓(xùn)練前后比較：組間比較：兩組患者上述評(píng)定結(jié)果干預(yù)組優(yōu)于對(duì)照組，組間比較有顯著統(tǒng)計(jì)學(xué)意義（P0.001）；訓(xùn)練時(shí)間水平比較：兩組患者上述評(píng)定結(jié)果在訓(xùn)練時(shí)間水平上有統(tǒng)計(jì)學(xué)差異（P0.001）；組間與訓(xùn)練時(shí)間的交互作用：髖膝關(guān)節(jié)活動(dòng)度、Fugl-Meyer運(yùn)動(dòng)功能量表（FMA）評(píng)分、功能性步行量表（FAC）評(píng)分、Berg平衡量表評(píng)分、Barthel指數(shù)評(píng)分及步態(tài)參數(shù)在組間與訓(xùn)練時(shí)間存在交互作用（P0.001），神經(jīng)功能缺損評(píng)分（下肢）（NIHSS）在組間與訓(xùn)練時(shí)間無(wú)交互作用（P=0.05）。 結(jié)論1傳統(tǒng)康復(fù)訓(xùn)練及Lokomat機(jī)器人訓(xùn)練均能為缺血性腦卒中偏癱患者提供安全有效的康復(fù)訓(xùn)練。2Lokomat機(jī)器人訓(xùn)練是本研究中最有效的訓(xùn)練方案。
[Abstract]:Objective to investigate the effect of Lokomat automatic robot gait training and evaluation system (Lokomat robot) on improving lower limb function of hemiplegic patients with ischemic stroke. To provide a safe and effective rehabilitation training method for patients with hemiplegia after ischemic stroke. Methods from March 2012 to May 2013, 40 inpatients from Department of Neurology and Rehabilitation, affiliated Hospital of Hebei Union University, were collected and matched according to their age, history and condition. The two groups were divided into intervention group and control group with 20 cases in each group. The intervention group received Lokomat robot rehabilitation training, while the control group received traditional rehabilitation training. 3. The intervention group and the control group were treated before training. After 6 weeks and 12 weeks of training, the neurological impairment score (lower extremities) (NIHSS), hip and knee motion assessment and Fugl-Meyer motor function scale (FMAA), functional walking scale (FAC), Berg balance scale, Barthel index and gait parameters were evaluated. The above evaluation results were statistically analyzed. Results 1 before training, the neurological impairment score (NIHSS of lower extremity, Fugl-Meyer motor function scale and FMAscore of hip and knee joint) were evaluated in the two groups. There was no significant difference in the scores of Berg balance scale, Barthel index and gait parameters between the two groups after training (P 0.05). The above evaluation results were significantly improved after training for 6 weeks and 12 weeks compared with those before training. The difference was statistically significant (P 0.05), and the 12 week training was significantly better than that of the 6 w training. The difference was statistically significant before and after training. 3 comparison between the two groups: the above evaluation results of the two groups were better than those of the control group. There was significant difference in the training time level between the two groups. The interaction between the two groups and the training time: the hip and knee motion and the Fugl-Meyer exercise. Functional scale (FMA) score, Functional walking scale (FAC) score and Berg balance scale score Barthel Index and gait parameters had interaction between group and training time (P 0.001), and there was no interaction between group and training time by neurological deficit score (NIHSS). Conclusion (1) traditional rehabilitation training and Lokomat robot training can provide safe and effective rehabilitation training for ischemic stroke hemiplegic patients .2Lokomat robot training is the most effective training program in this study.
【學(xué)位授予單位】：河北聯(lián)合大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R743.3

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