| 韩珍真,徐倩,朱冬燕,等.高精度经颅直流电刺激联合下肢康复机器人训练对脑卒中后下肢功能障碍的影响[J].中华物理医学与康复杂志,2026,48(8):691-695 |
| 高精度经颅直流电刺激联合下肢康复机器人训练对脑卒中后下肢功能障碍的影响 |
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| DOI：10.3760/cma.j.cn421666-20250518-00427 |
| 中文关键词: 高精度经颅直流电刺激 下肢康复机器人 脑卒中 下肢功能 |
| 英文关键词: High-precision transcranial direct current stimulation Lower limb rehabilitation robot Stroke Lower extremity function |
| 基金项目:国家重点研发计划项目(2022YFC2405605)；南通市社会民生科技计划项目(MSZ2025088)；南通市卫生健康委科研项目(QNZ2024027) |
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| 中文摘要: |
| 目的 观察高精度经颅直流电刺激(HD-tDCS)联合下肢康复机器人训练对脑卒中后下肢功能障碍患者下肢功能的影响。 方法 纳入脑卒中后下肢功能障碍患者104例，按随机数字表法分为HD-tDCS组34例、机器人组35例和联合组35例。3组患者均接受常规康复治疗(包括下肢关节活动度训练、肌力训练、耐力训练、体位转移训练、站立位平衡训练、步行训练等)，在此基础上，HD-tDCS组增加HD-tDCS治疗，机器人组增加下肢康复机器人训练，联合组则增加HD-tDCS同步下肢康复机器人训练。HD-tDCS同步下肢康复机器人训练每日1次，每周治疗5 d，持续治疗2周。治疗前和治疗2周后(治疗后)，采用Fugl-Meyer运动量表下肢部分(FMA-LE)、10 m步行试验(10MWT)、计时起立行走测试(TUGT)和Berg平衡量表(BBS)分别评估3组患者的下肢功能、步行能力、功能性移动能力和平衡能力。 结果 治疗后，3组患者的FMA-LE、10MWT、TUGT和BBS指标较组内治疗前均有显著改善(P<0.05)，且联合组治疗后的FMA-LE评分、10MWT、TUGT和BBS评分分别为(27.03±2.22)分、(16.11±3.04)s、(14.95±1.54)s和(44.94±3.02)分，均显著优于HD-tDCS组和机器人组治疗后，差异均有统计学意义(P<0.05)。 结论 HD-tDCS联合下肢康复机器人训练具有协同作用，可更为显著地改善脑卒中下肢功能障碍患者的下肢功能。 |
| 英文摘要: |
| Objective To investigate the efficacy of high-definition transcranial direct current stimulation (HD-tDCS) combined with synchronized lower-limb rehabilitation robot training on lower-limb function in patients with stroke-induced lower limb dysfunction. Methods A total of 104 stroke patients with lower-limb dysfunction were enrolled and randomly assigned to three groups using a random number table: the HD-tDCS group (n=34), the robot group (n=35), and the combined group (n=35). All participants received standard rehabilitation therapy, comprising range-of-motion exercises, muscle strengthening, endurance training, transfer training, standing balance training, and gait training. Additionally, the HD-tDCS group received HD-tDCS treatment, while the robot group underwent lower limb rehabilitation robot training, with the combined group receiving the both. Interventions were administered once daily, five days per week, for two weeks. Lower extremity function, walking ability, functional mobility, and balance were assessed before and after treatment using the Fugl-Meyer Assessment for Lower Extremity (FMA-LE), the 10-Meter Walk Test (10MWT), the Timed Up and Go Test (TUGT), and the Berg Balance Scale (BBS). Results Post-treatment assessments revealed significant improvements in FMA-LE, 10MWT, TUGT, and BBS scores across all three groups compared to baseline (P<0.05). Notably, the combined group demonstrated significantly superior outcomes compared to both the HD-tDCS and robot groups. The post-treatment scores for the combined group were as follows: FMA-LE (27.03 pm 2.22), 10MWT time (16.11 pm 3.04 s), TUGT time (14.95 pm 1.54 s), and BBS (44.94 pm 3.02), with statistically significant differences observed from the other two groups (P<0.05). Conclusions HD-tDCS synchronized with lower limb rehabilitation robot training exhibits a synergistic effect, offering a more effective intervention for improving lower extremity function in stroke patients with lower limb dysfunction compared to either modality alone. |
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