机器人辅助训练对脑卒中患者上肢运动功能效果的Meta分析

doi:10.3969/j.issn.1006-9771.2023.02.004

Abstract

Abstract: Objective To systematically review the efficacy of robot-assisted training on upper limb motor dysfunction in stroke patients. Methods Related literatures were searched in PubMed, Medline, Embase, Cochrane Library, Web of Science, CNKI, Wanfang Data, SinoMed, VIP data from July 1, 2019 to July 1, 2022. Two researchers screened the studies and extracted the data independently, and evaluated the methodological quality. Rev Man 5.4 was used for meta-analysis. Results A total of 19 randomised controlled trials with 1 258 subjects were finally included. The scores of Fugl-Meyer Assessment-Upper Extremity (SMD = 0.55, 95%CI 0.40 to 0.71, P < 0.001), modified Bathel Index (MD = 7.55, 95%CI 6.55 to 8.54, P < 0.001) and Motor Activity Log (SMD = -0.84, 95%CI -1.38 to -0.31, P = 0.002) were better in the experimental group than in the control group. However, no significant difference was found in the scores of Brunnstrom stages (upper extremity) (SMD = 0.61, 95%CI -0.08 to 1.30, P = 0.08) and modified Ashworth Scale (MD = -0.51, 95%CI -1.18 to 0.17, P = 0.14) between two groups. Conclusion Robot-assisted training could significantly improve the motor function of upper limbs in stroke patients.

Key words: stroke, robot-assisted training, upper exteremity, motor function, meta-analysis

CLC Number:

R743.3

ZHANG Liying, WANG Jiening, YU Xiaoming. Effect of robot-assisted training on upper limb motor in patients with stroke: a meta-analysis[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(2): 156-166.

Figures/Tables 11

纳入研究	n(T/C)	年龄(T/C)/岁	病程(T/C)	干预频率	干预方式及病程	结局指标
Taravati等^[26](2022)	37(17/20)	(50.94±17.20)/(55.75±11.61)	(10.94±8.02)个月/ (12.65±8.42)个月	每天30~45 min，每周5 d，共4周	T：常规+机器人辅助训练 C：常规康复训练	①②④
Frisoli等^[27](2022)	22(11/11)	(62±12)/(70±11)	(30±20) d/(37±24) d	每次45 min，每周3次，共6周	T：机器人辅助训练 C：常规物理治疗	①
苏丽丽等^[28](2022)	60(30/30)	(64.97±4.88)/(65.53±5.46)	(27.13±3.88) d/ (26.73±4.08) d	每次40 min，每天1次，每周5 d，共4周	T：作业治疗+机器人辅助训练 C：作业治疗+认知训练	①③
何艳等^[29](2021)	60(30/30)	(57.53±14.61)/(57.67±12.98)	(2.93±2.43)个月/ (2.33±1.69)个月	每次30 min，每天2次，每周5 d，共4周	T：常规+机器人辅助训练 C：常规康复训练	①③
Kim等^[30](2021)	47(23/24)	(57.17±15.12)/(62.08±12.42)		每次40 min,每天1次，每周5 d，共4周	T：作业治疗+机器人辅助训练 C：作业治疗	①③④
Chinembiri等^[31](2021)	45(20/25)	(57.25±9.23)/(57.72±7.37)		每次70 min，每天1次，每周5 d，共6周	T：常规+机器人辅助训练 C：常规康复治疗	①③
Franceschini等^[32](2020)	48(25/23)	70.0(60.3,72.0)/74.0(68.3,80.3)	31.0 (28.0, 33.0) d/ 31.0 (29.0, 33.0) d	每次45 min，每天1次，每周5 d，共6周	T：机器人辅助治疗 C：物理治疗	①
Carpinella等^[33](2020)	38(19/19)	67.0(58.0~70.0)/59.0(46.0~69.0)	7.0 (1.7~11.9)个月/ 5.3 (1.9~89.6)个月	每次45 min，每周5次，共20次	T：机器人辅助治疗 C：物理治疗	①④
梅英春^[34](2020)	32(16/16)	(55.94±1.82)/(54.75±1.43)		每天3 h，每周5 d，共8周	T：运动康复+机器人辅助训练 C：运动康复	①②④
李宇淇^[35](2020)	40(20/20)	(49.9±14.2)/(49.45±11.69)	1(1,2)个月/ 1.5(1,3)个月	每次60 min，每天1次，每周7 d，共2周	T：常规+机器人辅助训练 C：常规康复训练	①②③④
姜荣荣等^[36](2020)	40(20/20)	(63.15±11.79)/(65.10±9.14)	(73.75±52.32) d/ (79.70±52.25) d	每次30 min，每天1次，每周6 d，共2周	T：机器人辅助训练 C：作业治疗+认知训练	①③⑤
顾琦等^[37](2020)	46(23/23)	(62.09±10.75)/(59.57±11.08)	(24.35±6.34) d/ (24.96±5.47) d	每次30 min/次，每天1次，每周5 d，共9周	T：常规+机器人辅助训练 C：常规康复训练	①③④
Rodgers等^[38](2019)	469(233/236)	(59.9±13.5)/(59.4±14.3)	233(102~549) d/ 258(115~546) d	每次45 min，每周3次，共12周	T：机器人辅助训练 C：上肢强化训练	①③
Ramos等^[39](2019)	28(16/12)	(49.3±12.5)/(50.3±12.2)		每次1 h，每天1次，每周5 d，共4周	T：机器人辅助训练 C：常规康复训练	①⑤
Hsu等^[40](2019)	43(22/21)	(53.1±13.9)/(52.6±12.5)	(13.7±8.6)周/ (14.7±13.2)周	每次50 min，每周3次，共4周	T：机器人辅助训练 C：常规康复护理	①⑤
Dehem等^[41](2019)	45(23/22)	(67.3±11.1)/(68.6±19.1)	(194.7±17.0) d/ (191.3±12.3) d	每次45 min，每天1次，每周4 d，共9周	T：机器人辅助训练 C：常规康复训练	①③
张杨^[42](2019)	28(14/14)	(55.07±12.56)/(56.00±11.11)		每次30 min，每天1次，每个疗程5 d，共3个疗程	T：常规+机器人辅助训练 C：常规康复训练	①②③
张海燕等^[43](2019)	40(20/20)	(54.00±12.45)/(56.50±11.62)	(31.20±18.14) d/(30.55±17.63) d	每天1次，每周6 d，共4周	T：常规+机器人辅助训练 C：常规康复训练	①
翁静等^[44](2019)	90(45/45)	(55.48±12.18)/(54.56±11.74)	(2.48±1.11)个月/(2.36±1.23)个月	每次30 min，每天1次，共6周	T：常规+机器人辅助训练 C：常规康复训练	①③

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纳入研究	①	②	③	④	⑥	⑦	⑧	⑨	⑩	⑪	总分
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Effect of robot-assisted training on upper limb motor in patients with stroke: a meta-analysis

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