Value of lower extremity rehabilitation robot in the rehabilitation of stroke patients with severe hemiplegia and its effect on adverse psychology
MAO Zhenfang JIANG Zhiqiang LONG Jie LI Xuemei JIANG Qiying ZHANG Liangyong HUANG Liuyuan WEI Qiuyi
Department of Rehabilitation Medicine, the First Affiliated Hospital of Guangxi University of Science and Technology, Guangxi Zhuang Autonomous Region, Liuzhou 545002, China
Abstract:Objective To investigate the rehabilitation value of lower extremity rehabilitation robot for stroke patients with severe hemiplegia. Methods A total of 130 stroke patients with severe hemiplegia admitted to Department of Rehabilitation Medicine, the First Affiliated Hospital of Guangxi University of Science and Technology from January 2019 and December 2020 were selected as study subjects. They were divided into group A (65 cases) and group B (65 cases) by random number table method. group A was treated with folic acid + conventional rehabilitation training, and group B was treated with folic acid + conventional rehabilitation training + lower extremity rehabilitation robot, the course of treatment was six months. The motor function assessment scale (MAS) score, Barthel index, National Institutes of Health stroke scale (NIHSS) score, and anxiety and depression were compared between two groups before intervention, three and six months after intervention; patients in both groups were followed up by telephone for 180 d, and short form 36 (SF-36) scores were compared between two groups. Results Overall analysis showed that MAS score, Barthel index, NIHSS score between groups, time, and interaction were statistically significant between the two groups (P<0.05). Intra-group comparison: MAS score, Barhtel index, and NIHSS score were pairwise compared at different time points in two groups, and the differences were statistically significant (P<0.05). Inter-group comparison: after six months of intervention, MAS score and Barthel index in group B were higher than those in group A, and NIHSS score was lower than those in group A, and the differences were statistically significant (P<0.05). The overall analysis showed that there were statistically significant differences between groups, time, and interaction of self-rating anxiety scale (SAS) and self-rating depression scale (SDS) scores (P<0.05). Intra-group comparison: SAS and SDS scores were pairwise compared at different time points in the two groups, and the differences were statistically significant (P<0.05). Inter-group comparison: after three and six months of intervention, SAS and SDS scores in group B were lower than those in group A, and the differences were statistically significant (P<0.05). After intervention, the scores of physiological function, physiological function, physical pain, vitality, social function, emotional function, mental health, and total score of two groups were higher than those before intervention, and group B was higher than group A, and the differences were statistically significant (P<0.05). Conclusion Lower extremity rehabilitation robot can significantly improve the motor function of the affected limbs, nerve damage, and adverse psychology of stroke patients with severe hemiplegia, and improve the quality of life of patients, which is worth promoting.
毛珍芳 蒋志强 龙捷 李雪梅 蒋琪颖 张亮勇 黄柳远 韦秋义. 下肢康复机器人在脑卒中伴重度偏瘫患者康复中的价值及其对不良心理的影响[J]. 中国医药导报, 2023, 20(29): 78-82.
MAO Zhenfang JIANG Zhiqiang LONG Jie LI Xuemei JIANG Qiying ZHANG Liangyong HUANG Liuyuan WEI Qiuyi. Value of lower extremity rehabilitation robot in the rehabilitation of stroke patients with severe hemiplegia and its effect on adverse psychology. 中国医药导报, 2023, 20(29): 78-82.
[1] 纪红,许莉莎,宫为大,等.老年脑卒中后偏瘫患者康复训练效果的影响因素[J].中国老年学杂志,2021,41(14):3110-3113. [2] 夏颖,张红静,郭洪志,等.脑卒中偏瘫患者康复期抑郁、生活质量的相关因素研究[J].临床神经病学杂志,2007, 20(1):18-21. [3] Qiu YL. Clinical observation on scalp acupuncture combined with rehabilitation training for hemiplegia after stroke [J]. J Acupun Tuina Sci,2013,12(5):12-15. [4] Grzybowski A,Zülsdorff M,Wilhelm H,et al. Toxic optic neuropathies:an updated review [J]. Acta Ophthalmol,2015, 93(5):402-410. [5] 胡智伟.中国脑血管病防治指南[C]//浙江省中西医结合学会急救医学专业委员会第三次学术年会暨省级继续教育学习班论文汇编,2007:64-80. [6] 崔三生,李惠兰.上田敏法和MAS法在偏瘫患者评价中的相关性[J].中国康复医学杂志,1997,12(2):31-32. [7] Sisto SA. Motor Assessment Scale [M]. Encyclopedia of Clinical Neuropsychology,2011. [8] 向自仙,高文斌,陶婷,等.自我抽离训练对失眠障碍共病焦虑抑郁症状的改善效果[J].中国心理卫生杂志,2022, 36(10):831-837. [9] 杨莉霞,关东升,曹振浜,等.抗脑卒中治疗联合行为护理对老年蛛网膜下腔出血合并冠心病患者NIHSS及SDS评分的影响[J].中国老年学,2018,38(8):1811-1813. [10] 李勇强,张霞,邱怀德,等.下肢康复机器人用于治疗中枢神经损伤的研究进展[J].中国康复医学杂志,2023, 38(7):1012-1016. [11] Li LI,Chen S,Fang Y. To assess the reliability and validity of Chinese version SF-36 in evaluating the quality of life for subacute post-stroke patients [J]. J Rehabil Med,2017,32(5):509-515. [12] Gao Y, Hou H,Department R. Clinical Study on Acupuncture and Moxibustion Combined with Rehabilitation Training in the Treatment of Post-stroke Hemiplegia [J]. J Med,2019,7(11):23-25. [13] 刘建华,魏清川,胡秀茹,等.躯干控制训练联合肌内效贴对卒中后偏瘫患者躯干及平衡功能的临床疗效[J].中国康复,2020,35(11):582-586. [14] Didangelos T,Karlafti E,Kotzakioulafi E,et al. Vitamin B12 Supplementation in Diabetic Neuropathy:A 1-Year,Randomized,Double-Blind,Placebo-Controlled Trial [J]. Nutr,2021,13(2):395. [15] 秦路峰,王媛,彭玲.康复训练联合中频电疗和蜡疗用于脑卒中后偏瘫患者康复治疗中的应用进展[J].青岛医药卫生,2023,55(3):222-224. [16] Bold J,Sakata-Haga H,Fukui Y. Spinal nerve defects in mouse embryos prenatally exposed to valproic acid [J]. Anat Sci Int,2018,93(1):35-41. [17] 童锡宝,邵莹晖.叶酸联合甲钴胺治疗伴有高同型半胱氨酸血症的缺血性脑小血管病的效果研究[J].中外医学研究,2023,21(17):11-14. [18] Eckart S,H?觟rtnagl H,Kronenberg G,et al. Reduced nerve growth factor levels in stress-related brain regions of folate-deficient mice [J]. Neuro,2013,245:129-135. [19] 梁韬,李伟杰,杨宇德,等.前馈控制与反馈激活训练对脑卒中后偏瘫伴认知障碍恢复期患者躯干控制能力的疗效观察[J].中国现代药物应用,2023,17(12):158-161. [20] Ljungberg T,Bondza E,Lethin C. Evidence of the Importance of Dietary Habits Regarding Depressive Symptoms and Depression [J]. Int J Environ Res Public Health,2020, 17(5):1616. [21] 罗雪娇,梁菲菲,孙子慧,等.积极情绪干预联合健康管理对卒中偏瘫患者负面情绪及康复训练的影响[J].河北医药,2023,45(12):1914-1917. [22] 葛学玲,张万权,鮑丽芳,等.脑卒中偏瘫病人日常生活活动能力训练中引入活动分析法的临床实践[J].循证护理,2023,9(12):2192-2195. [23] 饶从柏.脑卒中肢体功能障碍患者应用康复治疗仪联合康复训练的效果[J].中外医学研究,2023,21(16):145-148. [24] 陆纬,李敏.甲钴胺联合叶酸、维生素B治疗高同型半胱氨酸血症的疗效[J].中国老年保健医学,2023,21(2):74-76. [25] 刘燕平,林茜,陈登钟,等.功能性电刺激同步下肢康复机器人对脑卒中后足下垂患者踝部功能的疗效研究[J]. 中国当代医药,2021,28(13):46-50. [26] Bin S,Mei DZ,Bin JW. Effects of fuzhengbutu acupuncture-moxibustion therapy on walking function in the patients with post-stroke hemiplegia[J]. J Acup Moxi,2019, 29(1):42-47.