三维上肢机器人减重辅助任务导向训练联合常规康复治疗脑卒中患者疗效观察OA

Objective To observe the effects of three-dimensional upper limb robot weight assisted task-oriented training combined with conventional rehabilitation therapy on upper limb motor function and activities of daily living(ADL)in stroke pa-tients.Methods A total of 50 stroke patients who were hospitalized in the Department of Rehabilitation of the Affiliated Hospital of Jining Medical College from July 2024 to July 2025 were randomly divided into control group and observation group,with 25 cases in each group.Both groups received routine drug therapy and conventional rehabilitation training(exercise therapy,traditional rehabilitation therapy,physical modalities therapy and electronic biofeedback therapy).The control group received routine task-ori-ented training,such as shoulder flexion and touching the target,in addition to the routine rehabilitation treatment,20 minutes per day,five times a week,and lasted for four weeks.In addition to the conventional rehabilitation therapy,the observation group re-ceived the task-oriented training with a three-dimensional upper limb robot weight assistance,which could offset 50%of the upper limb weight of the patients,20 minutes per day,five times a week,lasted for four weeks.Before and after treatment,the Fugl-Meyer Assessment for Upper Extremity(FMA-UE)and Functional Independence Measure(FIM)were used to assess the motor function of upper limbs and the ADL respectively.The near-infrared brain functional imaging equipment was used to detect the concentration of oxyhemoglobin(HbO2)in the brain region.The correlations among the changes in FMA-UE scores(ΔFMA-UE),FIM scores(ΔFIM),and regional cerebral HbO2 concentration changes(ΔHbO2)were analyzed.Results(1)Scores of FMA-UE and FIM:compared with those before treatment,the scores of FMA-UE and FIM in both groups increased significantly after treatment(P<0.05).Compared with the control group,the scores of FMA-UE and FIM in the observation group were significantly higher after treatment(P<0.05).(2)HbO2 concentration:compared with those before treatment,the HbO2 concentration in the channels of the right prefrontal cortex(RPFC)(CH21,CH3),the left prefrontal cortex(LPFC)(CH25,CH12),the middle prefrontal cortex(MPFC)(CH22),the right primary motor cortex(RM1)(CH1),the left primary motor cortex(LM1)(CH29)and the right primary sensory cortex(RS1)(CH2)increased significantly in both groups after treatment(P<0.05).Compared with the control group,the concentra-tion of HbO2 the above channels of the observation group was significantly higher after treatment(P<0.05).(3)Correlation between ΔFMA-UE and ΔFIM scores with ΔHbO2 concentration:the ΔFIM score was positively correlated with concentration ΔHbO2 in the channels of LPFC(CH9)in the control group(P<0.05).The ΔFMA-UE score was positively correlated with MPFC(CH6)and RM1(CH15)channel concentration ΔHbO2 in the observation group(P<0.05);the ΔFIM score was positively correlated with ΔHbO2 con-centration in the channels of MPFC(CH23),RS1(CH2),RM1(CH17)and LM1(CH28)(P<0.05).Conclusion Three-dimension-al upper limb robot weight assisted task-oriented training combined with conventional rehabilitation therapy can improve upper limb motor function and activities of daily living of stroke patients,which may be related to the activation of frontal lobe,motor cortex and sensory cortex.