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[神经康复的新机遇:中枢神经系统损伤后状况下的机器人辅助治疗]

[NEW OPPORTUNITIES IN NEURO-REHABILITATION: ROBOT MEDIATED THERAPY IN CONDITONS POST CENTRAL NERVOUS SYSTEM IMPAIRMENTS].

作者信息

Fazekas Gábor, Tavaszi Ibolya, Tóth András

出版信息

Ideggyogy Sz. 2016 Mar 30;69(5-6):148-54. doi: 10.18071/isz.69.0148.

Abstract

Decreasing the often-seen multiple disabilities as a consequence of central nervous system impairments requires broadening of the tools of rehabilitation. A promising opportunity for this purpose is the application of physiotherapy robots. The development of such devices goes back a quarter of century. Nowadays several robots are commercially available both for supporting upper and lower limb therapy. The aim is never to replace the therapists, but rather to support and supplement their work. It is worthwhile applying these devices for goal-oriented exercises in high repetition, which one physically fatiguing for the therapist or for the correction of functional movement by various strategies. Robot mediated therapy is also useful for motivation of the patient and making the rehabilitation programme more versatile. Robots can be used for assessment of the neuromotor status as well. Several clinical studies have been executed in this field, all over the world. Meta-analyses based on randomized, controlled trials show that supplementing the traditional physiotherapy with a robot-mediated component presents advantage for the patients. Further studies are necessary to clarify which modality and intensity of the exercises, in which group of patients, in which stage lead to the expected outcome.

摘要

减少因中枢神经系统损伤而经常出现的多种残疾需要拓宽康复手段。为此,一个很有前景的机会是应用物理治疗机器人。这类设备的研发可以追溯到四分之一世纪以前。如今,有几款机器人已在市场上销售,可用于辅助上肢和下肢治疗。其目的绝不是取代治疗师,而是支持和补充他们的工作。将这些设备应用于高重复性的目标导向性训练是值得的,因为这类训练对治疗师来说体力消耗较大,或者可通过各种策略纠正功能运动。机器人介导的治疗对激发患者积极性和使康复计划更加多样化也很有用。机器人还可用于评估神经运动状态。世界各地都在该领域开展了多项临床研究。基于随机对照试验的荟萃分析表明,在传统物理治疗中加入机器人介导的部分对患者有好处。有必要进一步开展研究,以明确哪种训练方式和强度、针对哪类患者、在哪个阶段能产生预期效果。

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