| 白森,贾胜男,王雪.神经肌肉电刺激联合智能康复机器人训练治疗老年脑梗死后上肢痉挛性偏瘫的临床研究[J].安徽医药,待发表. |
| 神经肌肉电刺激联合智能康复机器人训练治疗老年脑梗死后上肢痉挛性偏瘫的临床研究 |
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| 投稿时间：2026-08-19 录用日期：2026-10-29 |
| DOI： |
| 中文关键词: 智能康复机器人 神经肌肉电刺激 老年 脑梗死 上肢痉挛性偏瘫 |
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| 中文摘要: |
| 目的 探讨智能康复机器人结合神经肌肉电刺激对老年脑梗死后上肢痉挛性偏瘫的康复疗效。方法 纳入2023年2月至2024年5月本院老年脑梗死后上肢痉挛患者100例,采用随机数字表法分为两组:对照组48例,在常规药物及康复基础上接受智能康复机器人训练；观察组52例,在对照组方案上加用神经肌肉电刺激。两组均连续干预4周。比较两组上肢运动功能[简化Fugl-Meyer运动功能评定量表上肢部分(FMA-UE)]、各关节(肩、肘、腕、掌指)痉挛程度[改良Ashworth痉挛量表(MAS)]、神经功能[美国国立卫生研究院卒中量表(NIHSS)]、日常生活活动能力[改良Barthel指数(MBI)]、表面肌电信号[积分肌电值(iEMG)、均方根振幅(RMS)]、脑血流动力学[收缩期峰值流速(PSV)、平均流速(MFV)、血管阻力指数(RI)]、血清神经修复相关因子[脑源性神经营养因子(BDNF)、胰岛素样生长因子-1(IGF-1)]水平、不良反应发生情况。结果 干预2周后、4周后,观察组FMA-UE、MBI评分及iEMG、RMS值、BDNF、IGF-1水平、PSV、MFV显著高于对照组(均P＜0.05),NIHSS评分、各关节MAS评分及RI显著低于对照组(均P＜0.05)；两组不良反应发生率比较无差异(P＞0.05)。结论 本研究从运动功能、痉挛程度、表面肌电、脑血流动力学、血清神经营养因子多维度客观量化评估两种康复方案,证实机器人联合神经肌肉电刺激存在协同干预效应,为老年脑梗后上肢痉挛偏瘫提供多靶点康复循证方案。 |
| 英文摘要: |
| Objective To explore the rehabilitation effect of intelligent rehabilitation robot combined with neuromuscular electrical stimulation on upper limb spastic hemiplegia in elderly patients after cerebral infarction. Methods A total of 100 elderly patients with upper limb spasticity after cerebral infarction treated in our hospital from February 2023 to May 2024 were enrolled and divided into two groups by random number table method. The control group (48 cases) received intelligent rehabilitation robot training on the basis of conventional drugs and routine rehabilitation treatment. The observation group (52 cases) was additionally treated with neuromuscular electrical stimulation based on the regimen of the control group. Both groups received continuous intervention for 4 weeks. The upper limb motor function assessed by Fugl-Meyer Assessment-Upper Extremity (FMA-UE), spasticity degree of shoulder, elbow, wrist and metacarpophalangeal joints evaluated by Modified Ashworth Scale (MAS), neurological function assessed by National Institutes of Health Stroke Scale (NIHSS), activities of daily living assessed by Modified Barthel Index (MBI), surface electromyography indicators including integrated electromyogram (iEMG) and root mean square (RMS), cerebral hemodynamic parameters including peak systolic velocity (PSV), mean flow velocity (MFV) and resistance index (RI), serum levels of neurorepair-related factors including brain-derived neurotrophic factor (BDNF) and insulin-like growth factor-1 (IGF-1), and adverse reactions were compared between the two groups. Results At 2 and 4 weeks after intervention, the scores of FMA-UE (39.41±5.37, 48.35±6.15) and MBI, values of iEMG and RMS, levels of BDNF and IGF-1, as well as PSV and MFV in the observation group were significantly higher than those in the control group (all P<0.05). The NIHSS scores, MAS scores of each joint and RI in the observation group were obviously lower than those in the control group (all P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion This study quantitatively evaluated rehabilitation efficacy from multiple objective indicators including surface electromyography, cerebral hemodynamics and serum neurotrophic factors, and verified the synergistic effect of combined rehabilitation intervention, providing evidence-based rehabilitation strategy for elderly patients. |
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