本文選題：上肢康復機器人 + 腦卒中　； 參考：《廣州醫(yī)科大學》2017年碩士論文

【摘要】：目的:探討上肢康復機器人輔助虛擬現(xiàn)實技術對腦卒中恢復期偏癱上肢運動功能和活動能力的影響,以及上肢運動功能與活動能力康復的相關性。方法:選取符合入組標準的腦卒中后恢復期偏癱上肢功能障礙患者40例,使用隨機數(shù)字法分為試驗組和對照組,兩組患者均接受相同的基礎治療,包括藥物治療和運動治療。試驗組給予上肢康復機器人輔助虛擬游戲訓練,對照組給予常規(guī)作業(yè)治療。兩組患者治療周期均為2周,每天1次,共12次,每次持續(xù)30分鐘。兩組患者治療前后均進行運動功能和活動能力的評估,其中運動功能評估包括上肢和手的Brunnstrom分期、Fugl-Meyer評分,活動能力評估包括改良巴氏指數(shù)(MBI)、動作活動記錄量表(MAL)、上肢功能指數(shù)(UEFI)。結果:1.試驗組治療后上肢和手的Brunnstrom分期、FMA評分(上肢、腕、手和總分)均較治療前明顯提高(P0.05)。對照組治療后手的Brunnstrom分期、FMA評分(上肢、手和總分)均較治療前明顯提高(P0.05)。上肢Brunnstrom分期、FMA腕關節(jié)評分比治療前提高,差異無統(tǒng)計學意義(P0.05)。試驗組治療前后FMA上肢評分和總分改善程度優(yōu)于對照組,且差異具有統(tǒng)計學意義(P0.05)。2.兩組治療后改良巴氏指數(shù)(MBI評分)、上肢功能指數(shù)(UEFI)及動作活動記錄量表評分(包括患側肢體使用頻率和運動質量)較治療前均顯著性提高(P0.05)。試驗組治療前后患側肢體使用頻率和運動質量評分改善程度均優(yōu)于對照組,差異具有統(tǒng)計學意義(P0.05)。3.上肢和手的運動功能評分與活動能力評分成呈正相關性。其中患側肢體使用頻率與FMA評分(上肢、腕、手和總分)呈低度相關關系,運動質量與FMA評分(上肢、手和總分)呈顯著相關關系,與FMA腕關節(jié)評分呈低度相關。上肢功能指數(shù)(UEFI)與FMA評分(上肢、手和總分)呈顯著相關關系,與FMA腕關節(jié)評分呈低度相關關系。日常生活活動能力(MBI評分)與FMA手評分呈低度相關關系,與FMA上肢、腕關節(jié)評分及總分呈弱相關關系。4.兩組患者治療后1個月隨訪的MBI評分均較治療結束時提高,差異具有統(tǒng)計學意義(P0.05)。試驗組MBI評分改善程度優(yōu)于對照組,差異具有統(tǒng)計學意義(P0.05)結論:1.上肢康復機器人輔助虛擬現(xiàn)實技術訓練和常規(guī)作業(yè)治療均可以改善腦卒中恢復期偏癱上肢和手運動功能和活動能力。2.上肢康復機器人輔助虛擬現(xiàn)實技術訓練對腦卒中恢復期偏癱上肢和手的運動功能及使用頻率、運動質量的療效優(yōu)于常規(guī)作業(yè)治療,且對日常生活活動能力有一定遠期療效。3.康復訓練可促進腦卒中恢復期偏癱上肢和手功能的運動功能和活動能力的改善,且兩者的康復存在顯著正相關關系。
[Abstract]:Objective: to investigate the effect of robot assisted virtual reality (VR) technique on upper limb motor function and motor ability of hemiplegic patients with cerebral apoplexy and the correlation between upper limb motor function and rehabilitation of upper limb movement ability. Methods: forty patients with hemiplegic upper limb dysfunction in convalescence after stroke were selected and randomly divided into two groups: the experimental group and the control group. The two groups received the same basic treatment, including drug therapy and exercise therapy. The experimental group was given virtual game training assisted by upper limb rehabilitation robot, and the control group was treated with routine operation. Two groups of patients were treated for 2 weeks, once a day, a total of 12 times, each time for 30 minutes. Motor function and motor ability were evaluated before and after treatment in both groups. Motor function assessment included Brunnstrom stage and Fugl-Meyer score of upper limbs and hands. The evaluation of motor ability included modified pasteurian index (MBI), motor activity record scale (MALL) and upper limb function index (UEFI). The result is 1: 1. The Brunnstrom scores (upper limb, wrist, hand and total score) of upper limbs and hands in the experimental group were significantly higher than those before treatment (P 0.05). In the control group, the Brunnstrom stage and total score (upper limb, hand and total score) of the hand after treatment were significantly higher than those before treatment (P 0.05). The upper limb Brunnstrom stage and wrist joint score were higher than those before treatment, and the difference was not statistically significant (P 0.05). The improvement of FMA upper limb score and total score in the trial group was better than that in the control group before and after treatment, and the difference was statistically significant. After treatment, the modified pasteurian index (MBI), upper limb function index (UEFI) and motion record scale (including the frequency of limb use and motor quality of the affected side) were significantly higher than those before treatment (P 0.05). The improvement of limb use frequency and motor quality score in the experimental group was better than that in the control group before and after treatment, and the difference was statistically significant (P 0.05). The motor function scores of upper limbs and hands were positively correlated with motor ability scores. There was a low correlation between the frequency of limb use and FMA score (upper limb, wrist, hand and total score), a significant correlation between motor quality and FMA score (upper limb, hand and total score), and a low correlation with FMA wrist score. There was a significant correlation between UEFI and FMA score (upper limb, hand and total score), and a low correlation between UEFI and FMA wrist score. The activity of daily living (ADL) score showed a low correlation with FMA hand score, and a weak correlation with FMA upper limb, wrist joint score and total score. The MBI scores of the two groups were significantly higher than those at the end of the treatment after one month follow-up (P 0.05). The improvement of MBI score in the test group was better than that in the control group (P 0.05). The training of virtual reality technique and routine work therapy can improve the upper limb and hand motor function and movement ability of hemiplegia in convalescent stage of stroke. The upper limb rehabilitation robot assisted virtual reality technique training for upper limb and hand motor function and use frequency in convalescent stage of stroke is superior to routine operation treatment, and has a certain long-term effect on daily living ability. 3. The effect of virtual reality technology training on hemiplegic upper limb and hand in convalescent stage of stroke is better than that of routine operation. Rehabilitation training can promote the improvement of motor function and movement ability of upper limb and hand function of hemiplegia in convalescent stage of stroke, and there is a significant positive correlation between them.
【學位授予單位】：廣州醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：TP242;TP391.9;R743.3

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