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机器人辅助训练对脑卒中患者上肢功能康复的疗效:系统评价和荟萃分析。

Efficacy of Robot-Assisted Training on Rehabilitation of Upper Limb Function in Patients With Stroke: A Systematic Review and Meta-analysis.

机构信息

School of Sports Medicine and Health, Chengdu Sport University, Chengdu, China.

Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region, Chengdu, China.

出版信息

Arch Phys Med Rehabil. 2023 Sep;104(9):1498-1513. doi: 10.1016/j.apmr.2023.02.004. Epub 2023 Mar 1.

DOI:10.1016/j.apmr.2023.02.004
PMID:36868494
Abstract

OBJECTIVE

To systematically evaluate the effect of robot-assisted training (RAT) on upper limb function recovery in patients with stroke, providing the evidence-based medical basis for the clinical application of RAT.

DATA SOURCES

We searched online electronic databases up to June 2022, including PubMed, The Cochrane Library, Scopus, Web of Science, EMBASE, WanFang Data, CNKI, and VIP full-text databases.

STUDY SELECTION

Randomized controlled trials of the effect of RAT on upper extremity functional recovery in patients with stroke.

DATA EXTRACTION

The Cochrane Collaboration Tool for Assessing the Risk of Bias was used to assess study quality and risk of bias.

DATA SYNTHESIS

Fourteen randomized controlled trials involving 1275 patients were included for review. Compared with the control group, RAT significantly improved upper limb motor function and daily living ability. The overall differences were statistically significant, Fugl-Meyer Assessment for the Upper Extremity (FMA-UE; standard mean difference=0.69; 95% confidence interval, 0.34, 1.05; P=.0001), modified Barthel Index (standard mean difference=0.95; 95% confidence interval, 0.75, 1.15; P<.00001), whereas the differences in modified Ashworth Scale, FIM, and Wolf Motor Function Test scores were not statistically significant.

SUBGROUP ANALYSIS

Compared with the control group, the differences between FMA-UE and modified Barthel Index at 4 and 12 weeks of RAT, there were statistically significant, the differences of FMA-UE and modified Ashworth Scale in patients with stroke in the acute and chronic phases were statistically significant.

CONCLUSION

The present study showed that RAT can significantly enhance the upper limb motor function and activities of daily life in patients with stroke undergoing upper limb rehabilitation.

摘要

目的

系统评价机器人辅助训练(RAT)对脑卒中患者上肢功能恢复的影响,为 RAT 的临床应用提供循证医学依据。

资料来源

检索PubMed、The Cochrane Library、Scopus、Web of Science、EMBASE、万方数据、中国知网、维普中文期刊全文数据库,检索时限均为建库至 2022 年 6 月。

研究选择

RAT 对脑卒中患者上肢功能恢复影响的随机对照试验。

资料提取

采用 Cochrane 协作偏倚风险评估工具评价研究质量和偏倚风险。

资料综合

共纳入 14 项随机对照试验,包含 1275 例患者。与对照组比较,RAT 可明显改善上肢运动功能和日常生活能力,总体差异均有统计学意义,上肢 Fugl-Meyer 运动功能评定量表(FMA-UE)评分[标准均数差(SMD)=0.69,95%可信区间(CI):0.34,1.05;P=.0001]、改良 Barthel 指数(SMD=0.95,95%CI:0.75,1.15;P<.00001)差异有统计学意义,改良 Ashworth 量表、FIM 及 Wolf 运动功能测试评分差异无统计学意义。

亚组分析

RAT 治疗 4 周、12 周时 FMA-UE 及改良 Barthel 指数的差异均有统计学意义,急性和慢性期脑卒中患者 FMA-UE 及改良 Ashworth 量表的差异均有统计学意义。

结论

本研究表明 RAT 能明显增强脑卒中患者上肢运动功能和日常生活活动能力。

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