摘要
目的:探讨下肢外骨骼机器人步行训练对痉挛型双瘫脑性瘫痪患儿平衡功能的影响。方法:纳入2022年7月至2022年12月间就诊于浙江大学医学院附属儿童医院康复科的痉挛型双瘫脑性瘫痪患儿20例为治疗组,采用配对设计,年龄、性别、功能状态匹配的20例作为对照组。两组均给予常规的运动康复训练(运动疗法、悬吊训练、等速肌力训练),治疗组在此基础上增加下肢外骨骼机器人步行训练。在治疗前、治疗8周后对两组患儿进行表面肌电(sEMG)测试、动态平衡反应位移测试、静态平衡评分测试和儿童平衡量表(PBS)测试。结果:治疗前两组患儿臀大肌、臀中肌、股四头肌和胫前肌RMS数值,动态平衡反应位移、静态平衡评分及PBS评分组间差异无显著性意义(P>0.05),两组患儿治疗后臀大肌、臀中肌、股四头肌和胫前肌RMS数值,动态平衡反应位移、静态平衡评分及PBS评分均增加,治疗前后组内比较具有显著性意义(P<0.05),治疗后较治疗前有所改善,组间比较两组患儿治疗前后臀大肌、臀中肌和股四头肌RMS数值差值(臀大肌P=0.021;臀中肌P=0.016;股四头肌P=0.004)、动态平衡反应位移差值(前侧P=0.014;左侧P=0.003;右侧P=0.003)、静态平衡评分差值(P=0.005)及PBS评分差值(P=0.004)具有显著性意义,治疗组差值大于对照组,治疗组改善效果优于对照组。结论:下肢外骨骼机器人结合常规康复治疗能更加有效地改善痉挛型双瘫脑性瘫痪患儿平衡功能。
Objective:To investigate the effect of lower limb exoskeleton robots on balance function in children with spastic diplegia.Method:Twenty children with spastic diplegia who were admitted to the Department of Rehabilitation of the Children's Hospital of Zhejiang University School of Medicine from July 2022 to December 2022 were included in the treatment group.The other 20 children matched with age,gender and functional status were included in the control group.Both groups were given conventional rehabilitation training(exercise therapy,suspension training,isokinetic muscle strength training),and the treatment group were received the 30-min lower limb exoskeleton robot training 5 times a week for 8 weeks.Before and after treatment,the two groups were tested with surface electromyography(sEMG) data,dynamic balance response displacement,static balance score,and Pediatric Balance Scale(PBS).Result:Before treatment,there was no statistically significant difference(P>0.05) in sEMG values(gluteus maximus,gluteus medius,quadriceps femoris and tibialis anterior muscle),dynamic balance reaction displacement,static balance score,and PBS score between the two groups.There were significant improvements in the scores of these measurements(P<0.05) in both group before and after treatment.Compared with the control group,there were statistically significant differences in sEMG values(gluteus maximus P=0.021;gluteus medius P=0.016;quadriceps femoris P=0.004),dynamic balance reaction displacement(anterior P=0.014;left P=0.003;right P=0.003),static balance score(P=0.005),and PBS score(P=0.004) in the treatment group after treatment.Conclusion:Lower limb exoskeleton robot gait training combined with conventional rehabilitation treatment can effectively improve the balance function of cerebral palsy children with spastic diplegia.
作者
尹宏伟
余永林
杨安琪
徐莉
吕奕涛
李海峰
YIN Hongwei;YU Yonglin;YANG Anqi(The Children's Hospital of Zhejiang University School of Medicine,Hangzhou,Zhejiang,310003;不详)
出处
《中国康复医学杂志》
CAS
CSCD
北大核心
2024年第3期340-346,共7页
Chinese Journal of Rehabilitation Medicine
基金
浙江省“尖兵”研发攻关计划(2023C003)
浙江省中医药重点实验室(浙卫发[2022]32号)。
关键词
外骨骼机器人
痉挛型双瘫
平衡
儿童
脑性瘫痪
exoskeleton robots
spastic diplegia
balance
pediatric
cerebral palsy
