首页|康复机器人训练脑性瘫痪患者:改善下肢运动功能效果的Meta分析

康复机器人训练脑性瘫痪患者:改善下肢运动功能效果的Meta分析

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目的:系统评价康复机器人治疗脑性瘫痪患者下肢运动功能的临床效果,并比较不同机器人的疗效差异.方法:检索PubMed、Web of Science、Embase、Cochrane Library、中国知网、中国生物医学文献数据库、维普和万方数据库,搜集从建库至2024-04-10发表的关于康复机器人治疗脑性瘫痪患者运动功能障碍的随机对照试验.主要结局指标包括肌肉力量,肌张力、平衡功能、步速、步频、步长、步行耐力、下肢运动功能、日常生活活动能力.根据《国际功能、残疾和健康分类》对上述指标进行编码,通过Meta分析评价临床疗效并比较不同机器人的疗效差异.由2名研究人员进行文献检索与筛选,使用Cochrane 5.1.0偏倚风险评估工具对纳入文献进行质量评价.采用 RevMan 5.4软件和Stata 16.0软件进行Meta分析.结果:①最终纳入15篇文献,共512例患者,试验组260例、对照组252例.②Meta分析结果显示,与常规康复疗法相比,康复机器人可以提高身体结构和功能(SMD=0.41,95%CI:0.24-0.58,P<0.05)、活动(SMD=0.53,95%CI:0.41-0.65,P<0.05)和参与能力(MD=7.86,95%CI:1.54-14.18,P<0.05).其中,康复机器人可以改善脑性瘫痪患者下肢肌力、平衡功能、步速、步行耐力、下肢粗大运动功能和日常生活活动能力,但对步频、步长和肌张力的效果不明显.③网状Meta分析结果显示,步速:Innowalkpro>Gait trainer>Lokomat>3DCalt;6MWT评分:Gait trainer>Lokomat>Lokohelp>Innowalkro;GMFM-88D区评分:Lokohelp>Lokomat>KidGo>Innowalkpro>3DCalt;GMFM-88E区评分:Lokomat>Lokohelp>KidGo>3DCalt>Innowalkpro.结论:基于《国际功能、残疾和健康分类》,康复机器人训练可以改善脑性瘫痪患者下肢运动功能和日常生活活动能力.在改善步速方面,Innowalkpro机器人效果更优;在改善6MWT评分方面,Gait trainer机器人效果更优;在改善GMFM-D区评分方面,Lokohelp机器人效果更优;在改善GMFM-E区评分方面,Lokomat机器人效果更优.
Efficacy of rehabilitation robots on lower limb motor function in patients with cerebral palsy:a Meta-analysis
OBJECTIVE:To systematically evaluate the clinical effectiveness of rehabilitation robots in treating lower limb motor dysfunction in patients with cerebral palsy,and to compare the differences in therapeutic effects among different robots.METHODS:PubMed,Web of Science,Embase,Cochrane Library,CNKI,CBM,VIP and WanFang databases were searched to collect randomized controlled trials on rehabilitation robotics for the treatment of motor dysfunction in patients with cerebral palsy,published from database inception to April 10,2024.The main outcome indicators included muscle strength,muscle tension,balance function,step speed,step frequency,step length,walking endurance,lower limb motor function,and activities of daily living.The above indicators were coded according to the International Classification of Functioning,Disability and Health.Meta-analysis was performed to evaluate the clinical efficacy and compare the therapeutic efficacy of different rehabilitation robots.Literature search and screening were performed by two researchers,and the quality of the included literature was evaluated using the Cochrane 5.1.0 risk of bias assessment tool.Meta-analysis was performed using RevMan 5.4 software and Stata 16.0 software.RESULTS:(1)Fifteen articles were finally included,involving 512 patients with 260 in the experimental group and 252 in the control group.(2)The Meta-analysis results showed that rehabilitation robots could improve body structure and function[standardized mean difference=0.41,95%confidence interval(CI):0.24-0.58,P<0.05],activities(standardized mean difference=0.53,95%CI:0.41-0.65,P<0.05)and participation ability(mean difference=7.86,95%CI:1.54-14.18,P<0.05).In particular,the rehabilitation robot improved lower limb muscle strength,balance function,step speed,walking endurance,lower limb gross motor function,and activities of daily living in patients with cerebral palsy,but showed insignificant effects on step frequency,step length,and muscle tension.(3)The network Meta-analysis results showed that:step speed:Innowalkpro>Gait Trainer>Lokomat>3DCalt;6-minute walk test score:Gait Trainer>Lokomat>Lokohelp>Innowalkro;Gross Motor Function Measure-88D score:Lokohelp>Lokomat>KidGo>Innowalkpro>3DCalt;Gross Motor Function Measure-88E score:Lokomat>Lokohelp>KidGo>3DCalt>Innowalkpro.CONCLUSION:Based on the International Classification of Functioning,Disability,and Health,rehabilitation robot training can improve the lower limb motor function and activities of daily living in patients with cerebral palsy.The Innowalkpro robot was more effective in improving step speed;the Gait trainer robot was more effective in improving 6-minute walk test scores;the Lokohelp robot was more effective in improving Gross Motor Function Measure-88D zone scores;and the Lokomat robot was more effective in improving Gross Motor Function Measure-88E zone scores.

cerebral palsyrehabilitation robotlower limb motor functionwalkinggaitactivities of daily livingsystem evaluationnetwork Meta-analysisengineered rehabilitation

刘兴朝、胡通、马艳、王倩、魏晓辉、常万鹏、于少泓

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山东中医药大学,康复医学院,山东省 济南市 250355

山东中医药大学第二附属医院,山东省 济南市 250001

山东中医药大学,医学院,山东省 济南市 250355

脑性瘫痪 康复机器人 下肢运动功能 步行 步态 日常生活活动 系统评价 网状Meta分析 工程化康复

2025

中国组织工程研究
中国康复医学会,《中国组织工程研究与临床康复》杂志社

中国组织工程研究

北大核心
影响因子:1.387
ISSN:2095-4344
年,卷(期):2025.29(18)