首页|互动式头针结合上肢外骨骼机器人对脑卒中患者上肢功能的影响

互动式头针结合上肢外骨骼机器人对脑卒中患者上肢功能的影响

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目的 基于中枢-外周-中枢闭环理论,探讨互动式头针结合上肢外骨骼机器人对脑卒中患者上肢功能的影响.方法 选择2022年2月—2023年2月在山东大学附属省立第三医院康复治疗中心招募的40例脑卒中患者,采用随机数字表法将患者分为对照组和观察组,每组20例,均进行常规康复治疗.对照组在常规康复治疗的基础上进行上肢外骨骼机器人康复训练,每次25 min,1次/d,5 d/周,共4周.观察组在对照组治疗基础上新增头针留针,与上肢外骨骼机器人相结合进行互动式头针治疗.头针穴选取顶颞前斜线、顶旁2线的定位标准,留针25 min,间隔5 min施行捻转手法1次,1~2 min/次,1次/d,5 d/周,共4周.分别于治疗前后在ICF身体功能与结构领域使用Fugl-Meyer上肢运动功能评估量表(FMA-UE)评估上肢运动功能.在ICF活动领域使用Wolf运动功能测试(WMFT)评估患者上肢执行功能性任务的能力;在ICF参与领域使用改良Barthel指数(MBI)评估患者日常生活活动能力的独立性.结果 ① 身体功能与结构领域:与治疗前相比,2组治疗4周后FMA-UE评分均明显提高(P<0.05);与对照组相比,观察组治疗后FMA-UE评分提升更显著(P<0.05).② 活动领域:与治疗前相比,2组治疗4周后WMFT评分均明显提高(P<0.05);与对照组相比,观察组治疗后WMFT评分明显提高(P<0.05).③ 参与领域:2组治疗4周后MBI评分均明显提高(P<0.05);与对照组相比,观察组治疗后MBI评分提升更显著(P<0.05).结论 互动式头针结合上肢外骨骼机器人可有效改善脑卒中患者上肢运动功能、上肢执行功能性任务能力及日常生活活动能力.
Influence of Interactive Scalp Acupuncture Combined with Upper Limb Exoskeleton Robot on Upper Limb Function in Stroke Patients
Objective Based on the central-peripheral-central-closed loop theory,the study aimed to investigate the influence of interactive scalp acupuncture combined with upper limb exoskeleton robot on upper limb function in stroke patients.Methods A total of 40 stroke patients recruited in the Rehabilitation Treatment Center of the Shandong Provincial Third Hospital Affiliated to Shandong University from February 2022 to February 2023 were selected and randomly divided into control group and observation group,with 20 cases in each group.All patients were subjected to conventional rehabilitation treatment.In addition,upper limb exoskeleton robot rehabilitation training was performed in the control group,25 min each time,once a day,5 days a week,for 4 weeks.In the observation group,interactive scalp acupuncture combined with the upper limb exoskeleton robot was performed.The positioning standard for scalp acupuncture acupoints was the parieto-temporal anterior oblique line and parieto-parietal 2 lines,and the needle was left in place for 25 min,and twisting maneuver was applied once at an interval of 5 min,1-2 min per time,once a day,5 days a week,for 4 weeks in total.Pre-and post-treatment assessments of upper limb motor function before and after treatment were performed using the Fugl-meyer upper extremity motor function assessment scale(FMA-UE)within the domain of body func-tions and structures according to the Iinternational Cassification of Functioning,Disability and Health Framework(ICF).In addition,within the ICF activity domain,the Wolf motor function test(WMFT)was utilized to assess patients'abilities to perform functional tasks with their upper limbs.Finally,within the ICF participation domain,the modified Barthel index(MBI)was used to evaluate the independence of patients in activities of daily living.Results(1)Body function and structure domain:Compared with those before treatment,the FMA-UE score of both groups significantly increased after 4 weeks of treatment(P<0.05),and the observation group showed a more significant improvement in the FMA-UE score than the control group(P<0.05).(2)Activity domain:Compared with those before treatment,the WMFT score of both groups significantly increased after 4 weeks of treatment(P<0.05),and the observa-tion group showed a more significant improvement in the WMFT score than the control group(P<0.05).(3)Participation domain:The MBI score of both groups significantly increased after 4 weeks of treatment(P<0.05),and the observation group showed a more significant improvement in the MBI score than the control group(P<0.05).Conclusion Interactive scalp acupuncture combined with upper limb exoskeleton robot can significantly improve upper limb motor function,upper limb functional task performance,and activities of daily living in stroke patients.

strokeinteractive scalp acupunctureupper limb exoskeleton robotclosed-loop theoryupper limb function

王子豪、胡川、张海泉、王欣

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山东体育学院,山东 济南 250102

山东大学附属省立第三医院,山东 济南 250031

脑卒中 互动式头针 上肢外骨骼机器人 闭环理论 上肢功能

山东省中医药科技项目

2020M047

2024

康复学报
福建中医药大学

康复学报

CSTPCD
影响因子:0.545
ISSN:2096-0328
年,卷(期):2024.34(1)
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