《中国康复理论与实践》

《中国康复理论与实践》 ›› 2013, Vol. 19 ›› Issue (08): 701-709.

• 论文 •    下一篇

机器人辅助训练改善脑卒中患者下肢功能障碍的系统评价

郭佳宝，杨雨洁，岳雨珊，朱毅   

  1. 南京中医药大学第二临床医学院，江苏南京市210023。
  • 收稿日期:2013-03-12 修回日期:2013-04-18 出版日期:2013-08-25 发布日期:2013-08-25
  • 通讯作者: 朱毅

Effect of Robot-Assisted Training on Lower Extremities of Patients with Stroke: A Systematic Review of Randomized Controlled Trials

GUO Jia-bao, YANG Yu-jie, YUE Yu-shan, et al   

  1. The Second Clinical Medical School, Nanjing University of Chinese Medicine, Nanjing 210023, Jiangsu, China
  • Received:2013-03-12 Revised:2013-04-18 Published:2013-08-25 Online:2013-08-25

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摘要： 目的系统评价机器人辅助训练对脑卒中患者下肢功能障碍的康复效果。方法计算机检索PubMed、Medline、EMbase 、Cochrane Central Register of Controlled Trials (CENTRAL)、ISI Web of Knowledge、Ovid、中国知网、万方和维普数据库中关于机器人辅助训练改善脑卒中患者下肢运动功能障碍的随机对照试验，同时检索已纳入文献的参考文献。检索时间从建库至2013年3 月。2 名独立的研究人员依据Cochrane 协作网推荐的偏倚风险评估方法，对纳入文献的质量进行严格评估及资料提取，对符合标准的随机对照试验进行Meta 合并分析。统计分析采用RevMan 5.1 软件。结果共纳入12 个随机对照试验。Meta 分析显示，机器人辅助训练后，脑卒中患者的Fugl-Meyer 评分法下肢部分评分(WED=3.97, 95%CI: 2.84~5.10, Z=6.89, P<0.00001)及Berg 平衡量表评分(WED=3.13, 95%CI: 0.80~5.45, Z=2.63, P=0.008)与对照组比较，差异有统计学意义；但步频(WED=8.40, 95%CI: -0.95~17.75,Z=1.76, P=0.08)及步速(WED=0.03, 95%CI: -0.02~0.07, Z=1.18, P=0.24)与对照组比较，差异无统计学意义。纳入文献质量的Jadad评分，低质量4篇，高质量8 篇。结论机器人辅助训练在一定程度上能改善脑卒中患者的下肢运动功能。

关键词: 机器人辅助训练, 脑卒中, 下肢, 系统评价, 随机对照试验

Abstract: Objective To evaluate the effectiveness of robot-assisted training on lower extremities of patients with stroke. Methods PubMed, Medline, EMbase, Cochrane Central Register of Controlled Trials (CENTRAL), ISI Web of Knowledge, Ovid, China National Knowledge Infrastructure (CNKI), Wanfang Data and VIP Database for Chinese Technical Periodicals were searched for the randomized controlled trials (RCTs) about robot-assisted training for lower extremities of patients with stroke from the date of establishment to March 2013. The bibliographies of the retrieved studies were also searched. 2 independent researchers evaluated the included studies using the risk of bias provided by Cochrane Library. The extracted data were analyzed by RevMan 5.1 software. Results A total of 12 trials were discovered.Compared with conventional training, the robot-assisted training increased the score of Fugl-Meyer assessment (lower extremity)(WED=3.97, 95%CI: 2.84~5.10, Z=6.89, P<0.00001) and Berg Balance Scale (WED=3.13, 95%CI: 0.80~5.45, Z=2.63, P=0.008). However,the results of stride frequency (WED=8.40, 95%CI: -0.95~17.75, Z=1.76, P=0.08) and speed (WED=0.03, 95%CI: -0.02~0.07, Z=1.18, P=0.24) were not statistically significant. According to the Jadad Score of included studies, 4 of them were of low quality and 8 of them were of high quality. Conclusion The current evidence shows that to some extent, robot-assisted training could improve the lower extremities function.

Key words: robot-assisted training, stroke, lower extremities, systematic review, randomized controlled trial