王寒明 1王丛笑 1耿久军 1田建 1薛亚峰 1王欢1
作者信息
- 1. 首都医科大学附属北京康复医院·康复诊疗中心,北京 100144
- 折叠
摘要
Abstract
Objective:To investigate the effects of Lokomat robot-assisted gait training(RAGT)on lower limb motor function and cerebral hemodynamics in patients with severe hemiplegia based on conventional rehabilitation therapy.Methods:A total of 126 patients with severe hemiplegia were selected and divided into a control group(conventional rehabilitation therapy,n=69)and an observation group(conventional rehabilitation plus RAGT training,n=57)according to different rehabilitation methods.After propensity score matching,each group included 44 cases.Cerebral hemodynamics-related indicators,balance function and lower limb motor function scores,gait parameters,levels of angiopoietin-1(Ang-1)and vascular endothelial growth factor(VEGF),and cerebral hemodynamics indicators including maximum blood flow velocity(Vmax),minimum blood flow velocity(Vmin),peripheral resistance(RV),and dynamic resistance(DR)were compared before treatment,at 2 weeks,and at 5 weeks of treatment.A difference-in-differences(DID)model was constructed to analyze changes in vascular active sub-stances and cerebral hemodynamics indicators after treatment in patients with severe hemiplegia.Results:After treatment,the observation group showed higher scores than the control group in the Berg Balance Scale(P<0.001),Fugl-Meyer Assessment(P<0.001),Stroke Rehabilitation Motor Function Assessment Scale(P<0.001),as well as faster walking speed,longer step length,and higher step frequency(P<0.05).Ang-1 and VEGF levels in the observation group were higher than those in the control group(P<0.001).Vmax and Vmin were higher than in the control group,while RV and DR were lower than in the control group(P<0.05).DID model results showed that the group×time interaction had a significant effect on improving vas-cular active substances and cerebral hemodynamics indicators(P<0.05).Conclusion:On the basis of conventional rehabilita-tion therapy,adjunctive RAGT training has a favorable clinical therapeutic effect,significantly optimizes cerebral hemodynamics in patients with severe hemiplegia,promotes the secretion of substances related to angiogenesis,and markedly improves patients'balance ability,lower limb motor function,and gait parameters.关键词
偏瘫/机器人辅助步行训练/下肢/运动功能/脑血流动力学Key words
Hemiplegia/Robot-assisted gait training/Lower limbs/Motor function/Cerebral hemodynamics分类
医药卫生
