| 张圣含,刘奕,张海翔,关世裕,李漫霞,张媛媛,冯小军.下肢外骨骼机器人辅助步行训练对脑卒中偏瘫患者步行能力的影响[J].中国康复,2026,41(8):451-456 |
| 下肢外骨骼机器人辅助步行训练对脑卒中偏瘫患者步行能力的影响 |
| Effects of lower-limb exoskeleton robotic-assisted gait training on walking ability in stroke patients with hemiplegia |
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| DOI：10.3870/zgkf.2026.08.001 |
| 中文关键词: 下肢外骨骼机器人 脑卒中 运动功能 步行能力 |
| 英文关键词: lower-limb exoskeleton robot stroke motor function walking ability |
| 基金项目:安徽省临床医学研究转化专项(202427b10020018)；安徽省教育厅高校自然重点项目（2023AH053157）；安徽医科大学第二附属医院国家自然科学基金孵育计划（2023GMFY04）；安徽省转化医学研究院科研基金项目（2022zhyx-C75） |
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| 中文摘要: |
| 目的：观察下肢外骨骼机器人辅助步行训练（RAGT）对脑卒中患者步行能力的改善效果，为优化临床步态康复方案提供客观依据。方法：将36例脑卒中患者随机分至机器人组和对照组，每组18例。2组均接受常规康复治疗，机器人组在此基础上进行RAGT，对照组则进行传统步行训练，治疗周期为2周。治疗前后分别评估2组患者下肢Brunnstrom分期、功能性步行分级（FAC）、改良Barthel指数（MBI）及步态参数（包括步速、步幅、步宽、步相角及患侧单步时间占比）。结果：治疗后，2组患者的下肢Brunnstrom分期、FAC、MBI、步速、步幅以及患侧单步时间占比均较治疗前显著提高（P<0.05），步相角较治疗前显著减小（P<0.05）。治疗后组间比较显示，机器人组在下肢Brunnstrom分期、步速、步幅及患侧单步时间占比均高于对照组（P<0.05），步相角的减小幅度高于对照组（P<0.05）。此外，治疗后机器人组的步宽较治疗前显著减小（P<0.05），2组间比较差异无统计学意义。结论：RAGT可有效改善脑卒中患者下肢运动功能和步态参数，具有一定的临床应用价值。 |
| 英文摘要: |
| Objective: To investigate the efficacy of lower-limb exoskeleton robotic-assisted gait training (RAGT) on improving the walking ability of stroke patients, thereby providing objective evidence for the optimization of clinical gait rehabilitation protocols.Methods: Totally, 36 eligible stroke patients were randomly allocated to the RAGT group and the control group, with 18 participants in each group. Both groups received routine rehabilitation therapy; additionally, the RAGT group underwent RAGT, while the control group received conventional gait training. The intervention duration was 2 weeks. Pre- and post-intervention assessments were conducted to evaluate the lower limb Brunnstrom stage, Functional Ambulation Category (FAC) score, Modified Barthel Index (MBI) score, and gait parameters (including walking speed, stride length, step width, toe out angle, and the proportion of single-step time contributed by the affected limb) in patients from both groups. Results: No statistically significant differences were found in all baseline characteristics between the two groups (P<0.05). After the intervention, both groups demonstrated significant improvements in lower limb Brunnstrom stage, FAC, MBI, walking speed, stride length, and the proportion of single-step time contributed by the affected limb compared with pre-intervention levels (P<0.05), while toe out angle was significantly reduced (P<0.05). Post-intervention intergroup comparisons revealed that the robot group had higher scores in lower limb Brunnstrom stage, walking speed, stride length, and the proportion of single-step time contributed by the affected limb than the control group (P<0.05), and the magnitude of reduction in toe out angle was greater in the robot group (P<0.05). Additionally,the robot group exhibited a significant reduction in step width after the intervention compared with baseline (P<0.05), but no significant intergroup difference was noted in this parameter. Conclusion: RAGT can effectively improve lower limb motor function and gait parameters in stroke patients, demonstrating potential clinical application value. |
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