下肢康复机器人联合头针治疗对老年缺血性卒中患者步行效率和协调功能影响调查OA北大核心CSTPCD

Objective To analyze the effects of lower limb rehabilitation robot combined with scalp acupuncture on the walking efficiency and coordination function in elderly patients with ischemic stroke. Methods This study was a prospective study,which consecutively enrolled elderly patients with ischemic stroke who were treated at Shangqiu Hospital of Traditional Chinese Medicine from December 2022 to June 2023 as the study subjects.The enrolled patients were divided into the control group and the observation group using the random number table.All the patients in these two groups received conventional intervention.Additionally,the patients in the control group received the flat walking lower limb rehabilitation robot training(30 min each time,3 times a week),while those in the observation group received the flat walking lower limb rehabilitation robot training combined with scalp acupuncture(retention of needle for 30 min,once a day,5 days per week).The treatment duration of both groups was 4 weeks.Assessments were conducted before and 4 weeks after the treatment.The activity of daily living scale(ADL)was used to evaluate the patients'daily living ability,the Fugl-Meyer assessment(FMA)scale was used to assess the lower limb motor function,the Berg balance scale(BBS)was used to assess the balance function,and the functional ambulation category(FAC)scale,6 min walking distance,and the timed up and go(TUG)test were used to assess the walking function.The manual muscle testing(MMT)was used to assess the muscle strength of the quadriceps femoris and hamstrings.The absolute trajectory error(ATE)and completion time were recorded by the Prokin system to assess the patients'proprioception function.In addition,the surface electromyography analysis system was used to analyze the root mean square(RMS)of the electromyography of the rectus femoris,hamstrings,tibialis anterior,and medial head of gastrocnemius of the patients. Results After treatment,the ADL scores of both groups were higher than those of the same group before treatment,and the ADL scores of the observation group were higher than those of the control group[(85.21±7.55)scores vs.(73.51±6.90)scores,P＜0.001].After treatment,the FMA scale scores and the BBS scores of both groups were higher than those of the same group before treatment,and the FMA scale scores[(28.74±3.14)scores vs.(22.31±2.77)scores,P＜0.001]and the BBS scores[(41.82±3.21)scores vs.(30.49±2.78)scores,P＜0.001]of the observation group were higher than those of the control group.After treatment,the FAC scale scores and 6 min walking distance of both groups were better than before treatment,while the TUG test time was shorter than before treatment.After treatment,the above indicators in the observation group were better than those in the control group[FAC scale scores:(3.89±0.41)scores vs.(2.87±0.34)scores,P＜0.001;6 min walking distance:(314.38±18.93)m vs.(269.05±20.31)m,P＜0.001;TUG:(24.93±4.24)s vs.(29.84±4.85)s,P＜0.001].The MMT scores of the quadriceps femoris and hamstrings of patients in both groups were increased after treatment,and the above indicators in the observation group were higher than those in the control group after treatment(both P＜0.05).After treatment,the ATE and completion time of both groups were lower than before treatment,and the above indicators in the observation group were lower than those of the control group after treatment[ATE:(47.57±5.12)％vs.(55.43±5.49)％,P＜0.001;completion time:(80.43±6.78)s vs.(91.27±8.01)s,P＜0.001].After treatment,the RMSs of the rectus femoris,hamstrings,tibialis anterior,and medial head of gastrocnemius of both groups were higher than before treatment,and were higher in the observation group than in the control group after treatment,the differences were statistically significant. Conclusions The use of lower limb rehabilitation robot combined with scalp acupuncture can significantly improve the walking efficiency and coordination function in elderly patients with ischemic stroke,and improve their daily living ability,proprioception function,and myoelectric level.