摘要
目的:评价机器人辅助训练对脑卒中早期康复患者下肢运动和平衡功能的影响。方法:检索Pub Med、EMbase、Clinicaltrials.gov、EBSCO、中国知网、万方数据库,搜集关于机器人辅助训练改善脑卒中早期(病程在1个月内)患者下肢运动和平衡功能的随机对照试验(RCT)。检索时限设定为建库至2017年10月,由2位评价者独立进行文献筛选、基本资料提取和偏倚风险评估后,采用Rev Man 5.3软件进行Meta分析。结果:最终纳入5个RCT中,中文文献4篇,英文文献1篇。Meta分析显示:脑卒中早期康复患者应用机器人辅助训练后,患者下肢运动功能Fugl-Meyer评分[SMD=0.76,95%CI(0.46,1.07),P<0.01]及Berg平衡量表评分[SMD=0.62,95%CI(0.32,0.92),P<0.01)较对照组均有明显提高,差异有统计学意义。结论:机器人辅助训练可提高脑卒中早期康复患者的下肢运动和平衡功能。以上结论尚需更多大样本、多中心、高质量的随机对照试验加以验证,深入探讨康复机器人辅助训练的疗效及脑卒中康复不同时期的患者减重幅度、牵引力、步行速度等治疗参数的标准。
Objective：To systematically review the effect of robot-assisted training on lower extremities function of stroke patients in the early stage of rehabilitation. Methods：We electronically searched databases including Pub Med, EMbase, Clinicaltrials.gov,EBSCO, CNKI, and Wan Fang to collect randomized controlled trials（RCTs） about robot-assisted training for improvement of lower extremities motor and balance function of patients in early stage of stroke（duration〈1 month） which published before October 2017.Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Meta-analysis was performed by using Rev Man 5.3 software. Results：Five trials involving four Chinese literatures and one English literature were enrolled in this Meta-analysis. The results demonstrated that, compared with conventional training group, the score of Fugl-Meyer assessment（lower extremity） in robot-assisted training group was increased [SMD 0.76; 95%CI（0.46, 1.07）, P〈0.01], and Berg balance scale was also increased [SMD 0.62; 95%CI（0.32, 0.92）, P〈0.01]. Conclusion：Current evidence showed that robot-assisted training could improve the lower extremities motor function and balance of patients in early stage of stroke. It still needs to be confirmed in a larger scale of controlled studies with a more homogeneous group of patients and a longer follow-up. Optimum parameters of rehabilitation robot, such as body weight support, guide force, gait speed, need to be further studied in patients in different stages of stroke.
作者
李雪静
吴佳佳
叶涛
唐强
LI Xuejing;WU Jiajia;YE Tao;TANG Qiang(Graduate College, Heilongjiang University of Traditional Chinese Medicine, Harbin, Heilongjiang 150040, China;College of Rehabilitation Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China;The Second Affiliated Hospital, Heilont~iang University of Traditional Chinese Medicine, Harbin, Heilongjiang 150001, China)
出处
《康复学报》
2018年第2期61-66,共6页
Rehabilitation Medicine
基金
国家自然科学基金项目(81273818)
黑龙江省高校科技创新团队计划项目(2013TD007)
关键词
脑卒中
早期康复
下肢
机器人辅助训练
META分析
stroke
early rehabilitation
lower extremities
robot-assisted training
Meta-analysis
