中风患者增强的神经可塑性与步态恢复：主动和被动机器人训练模式的比较分析

Enhanced neuroplasticity and gait recovery in stroke patients: a comparative analysis of active and passive robotic training modes.

作者信息

Yu Yong, Huang Wenhao, Tuerxun Halikejiang, Zheng Yadan, Su Liujie, Li Xin, Dou Zulin

机构信息

Department of Rehabilitation Medicine, The Third Affiliated Hospital of Sun Yat- Sen University, Guangzhou, China.

Department of Rehabilitation Medicine, The First People's Hospital of Kashi, Kashi, China.

出版信息

BMC Neurol. 2025 May 31;25(1):239. doi: 10.1186/s12883-025-04226-0.

DOI:10.1186/s12883-025-04226-0

PMID:40450196

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12125807/

Abstract

BACKGROUND

Stroke is a leading cause of long-term disability, with lower limb dysfunction being a common sequela that significantly impacts patients' mobility and quality of life. Robotic-assisted training has emerged as a promising intervention for gait rehabilitation post-stroke. This study aims to compare the effects of active and passive lower limb robotic training on gait recovery in stroke patients.

METHODS

This randomized controlled trial included 45 stroke patients who were divided into three groups: active mode group, passive mode group, and control group. All participants received standard rehabilitation therapy, while the intervention groups additionally received 20 min of robotic training (active or passive mode) daily for 10 sessions over two weeks. Outcome measures included the Fugl-Meyer Assessment (FMA) for motor function, motor evoked potentials (MEP) for neurophysiological assessment, and functional near-infrared spectroscopy (fNIRS) for brain imaging.

RESULTS

Both active and passive groups showed significant improvements in FMA scores and MEP measures compared to pre-treatment baselines (P < 0.01). The active group exhibited significantly greater FMA score improvements (P = 0.02) and MEP amplitudes (P < 0.01) than the passive group. Additionally, fNIRS results indicated significantly enhanced brain activation in the affected motor cortex in the active group post-treatment (F = 5.82, P = 0.026), a change not observed in the passive group. These findings underscore the clinical superiority of active robotic training in enhancing motor recovery post-stroke.

CONCLUSION

Active mode robotic training is more effective than passive mode training in improving motor function and neurophysiological outcomes in stroke patients. These findings support the preferential use of active mode robotic training in clinical rehabilitation settings for enhancing gait recovery post-stroke. Further research with larger sample sizes and longer follow-up periods is warranted to confirm these results and explore long-term benefits.

摘要

背景

中风是导致长期残疾的主要原因，下肢功能障碍是常见的后遗症，严重影响患者的行动能力和生活质量。机器人辅助训练已成为中风后步态康复的一种有前景的干预措施。本研究旨在比较主动和被动下肢机器人训练对中风患者步态恢复的影响。

方法

这项随机对照试验纳入了45名中风患者，分为三组：主动模式组、被动模式组和对照组。所有参与者均接受标准康复治疗，而干预组在两周内每天额外接受20分钟的机器人训练（主动或被动模式），共进行10次训练。结果测量包括用于运动功能评估的Fugl-Meyer评估（FMA）、用于神经生理学评估的运动诱发电位（MEP）以及用于脑成像的功能近红外光谱（fNIRS）。

结果

与治疗前基线相比，主动组和被动组的FMA评分和MEP测量值均有显著改善（P < 0.01）。主动组的FMA评分改善幅度（P = 0.02）和MEP波幅（P < 0.01）均显著高于被动组。此外，fNIRS结果表明，主动组治疗后患侧运动皮层的脑激活显著增强（F = 5.82，P = 0.026），被动组未观察到这种变化。这些发现强调了主动机器人训练在促进中风后运动恢复方面的临床优势。