手部外骨骼机器人联合Bobath训练在脑卒中偏瘫患者手功能康复治疗中的应用效果观察OACSTPCD

Objective:To observe the application of hand exoskeleton robot combined with Bobath training in the rehabilitation treatment of hemiplegia after stroke(HAS).Methods:From October 2022 to October 2023,120 pa-tients with HAS hand dysfunction admitted to our hospital were collected and randomly separated into a Bobath group(n=40,routine intervention+Bobath technique),a robot group(n=40,routine intervention+training using hand exoskeleton robots),and a combined group(n=40,routine intervention+Bobath technique+training using hand exoskeleton robots)using a random number table method.Three groups were compared in terms of hand func-tion,upper limb motor function,daily living ability,and the activation status of corresponding cortical areas detec-ted by resting state functional magnetic resonance imaging(fMRI).Results:Repeated measures analysis of variance showed that the Carroll hand function assessment(UEFT),Fugl-Meyer upper limb assessment(FMA-UL),and Bathel index(BI)scores of the three groups increased gradually with the extension of time after treatment.Among them,the combined group had higher scores in the above three items than the Bobath group and robot group after 2 and 4 weeks of intervention(P＜0.05).After 4 weeks of intervention,the activation rates of the central anterior gyrus,auxiliary motor area,parietal occipital lobe,and basal ganglia in all three groups were higher than before in-tervention(P＜0.05),and among them,the activation rates of other brain areas except for the occipital lobe and basal ganglia in the combined group were higher than those in the Bobath group and robot group(P＜0.01).Con-clusion:Hand exoskeleton robot combined with Bobath training for HAS patients can effectively activate functional brain regions,obviously ameliorate hand function,and obviously enhance daily activity abilities.