目的：探讨等速肌力训练结合上肢康复机器人对脑卒中恢复期偏瘫患者上肢功能恢复、生活质量及 神经可塑性的影响。方法：选取 2021 年 3 月—2024 年 3 月在宝鸡市人民医院诊治的 102 例脑卒中恢复期偏瘫患者 作为研究对象，按照随机数字表法将其分为对照组（51 例，常规训练）和研究组（51 例，等速肌力训练结合上肢 康复机器人训练），比较两组患者上肢功能恢复、生活质量及神经可塑性。结果：与训练前相比，两组患者训练 3 个月后上肢动作研究量表（ARAT）、Fugl-Meyer 上肢运动功能评价量表（FMA-UE）评分升高（P<0.05），与对照 组相比，研究组训练 3 个月后 ARAT、FMA-UE 评分更高（P<0.05）。与训练前相比，两组患者训练 3 个月后脑卒 中专用生活质量量表（SS-QOL）各维度评分升高（P<0.05），与对照组相比，研究组训练 3 个月后 SS-QOL 各维度 评分更高（P<0.05）。与训练前相比，两组患者训练 3 个月后斜率不对称指数、cM1-Slope、RMT 不对称指数降低， iM1-Slope、cM1-RMT 升高（P<0.05），与对照组相比，研究组训练 3 个月斜率不对称指数、cM1-Slope、RMT 不对 称指数更低，iM1-Slope、cM1-RMT 更高（P<0.05）。结论：等速肌力训练结合上肢康复机器人训练应用于脑卒中恢 复期偏瘫患者，可促进上肢功能恢复，提升生活质量，改善神经可塑性。

Objective: To explore the effect of isokinetic exercise combined with upper limb rehabilitation robot on upper limb function recovery, quality of life and neuroplasticity in stroke patients with hemiplegia during the recovery period. Methods: 102 stroke patients with hemiplegia treated in Baoji People’s Hospital from March 2021 to March 2024 were selected and divided into the control group (n=51) and the study group(n=51) using a random number table. The control group received conventional rehabilitation training, and the study group received isokinetic exercise combined with upper limb rehabilitation robot training. Upper limb function recovery, quality of life and neuroplasticity of patients in the two groups were compared. Results: Compared with that before intervention, the scores of action research arm test (ARAT) and Fugl-Meyer assessment of the upper extremity (FMA-UE) in the two groups were both raised after 3 months of training (P<0.05), and the ARAT and FMA-UE scores in the study group were higher after 3 months of training than those in the control group (P<0.05). Compared with that before training, the scores of various dimensions of the stroke-specific quality of life scale (SS-QOL) in the two groups were both increased after 3 months of training (P<0.05), and the scores of various dimensions of SS-QOL in the study group were higher after 3 months of training than those of the control group (P<0.05). Compared with that before training, the slope asymmetry index, cM1 Slope, and RMT asymmetry index decreased in both groups after 3 months of training (P<0.05), while iM1 Slope and cM1 RMT increased in both groups after 3 months of training (P<0.05). Moreover, compared with the control group, the slope asymmetry index, cM1 Slope, and RMT asymmetry index were lower in the study group after 3 months of training (P<0.05), while iM1 Slope and cM1 RMT asymmetry index were higher in the study group after 3 months of training (P<0.05). Conclusion: The application of isokinetic exercise combined with upper limb rehabilitation robot training in stroke patients with hemiplegia during the recovery period can promote upper limb function recovery, improve quality of life, and enhance neuroplasticity.

收稿日期：2024-08-06  录用日期：2024-08-29 

Received Date: 2024-08-06  Accepted Date: 2024-08-29

基金项目：宝鸡市卫生健康委员会 2019 年度科研计划立项课题（2020-14） 

Foundation Item: Scientific Research Plan Project of Baoji Municipal Health Commission in 2019(2020-14) 

通讯作者：周小云，Email：jsntxiaoyun@126.com 

Corresponding Author: ZHOU Xiaoyun, Email: jsntxiaoyun@126.com 

引用格式：杨兰，周小云，许坚，等 . 等速肌力训练结合上肢康复机器人对脑卒中恢复期偏瘫患者上肢功能恢复、生活质量及神 经可塑性的影响 [J]. 机器人外科学杂志（中英文），2024，5（6）：1111-1115. 

Citation: YANG L, ZHOU X Y, XU J, et al. Effect of isokinetic excercise combined with upper limb rehabilitation robot on upper limb function recovery, quality of life and neuroplasticity in stroke patients with hemiplegia during the recovery period[J]. Chinese Journal of Robotic Surgery, 2024, 5(6): 1111-1115.

[1] 刘小红 , 刘景珍 , 温启强 . 手足十二针联合肢体评估训练康复 系统在脑卒中偏瘫患者肢体功能恢复中的应用观察 [J]. 四川中 医 , 2022, 40(6): 194-197. 

[2] 孙晓燕 , 陈艳丽 , 颜亚博 , 等 . 低频电刺激联合康复训练治疗脑 卒中偏瘫患者效果及运动功能 , 自我效能的影响 [J]. 现代生物 医学进展 , 2023, 23(14): 2750-2753. 

[3] 刘银霞 , 董虹丽 , 汪军华 . 运动想象训练联合任务导向性功能 训练对脑卒中偏瘫患者下肢功能恢复的影响 [J]. 中华物理医学 与康复杂志 , 2024, 46(4): 322-324. 

[4] 雷思艺 , 葛瑞东 , 高蓓瑶 , 等 . 机器人定量辅助训练对脑卒中恢 复期偏瘫患者上肢异常运动模式的即刻影响 : 一项表面肌电研 究 [J]. 中日友好医院学报 , 2022, 36(5): 267-271. 

[5] 毛珍芳 , 蒋志强 , 龙捷 , 等 . 下肢康复机器人在脑卒中伴重度偏 瘫患者康复中的价值及其对不良心理的影响 [J]. 中国医药导报 , 2023, 20(29): 78-82. 

[6] 孙琦 , 谢晶军 . 上肢康复机器人对脑卒中患者上肢功能障碍的 影响 [J]. 中华物理医学与康复杂志 , 2023, 45(09): 833-835. 

[7] 聂鹏坤 , 杨华 , 赵晓峰 , 等 . 中风患者 Fugl-Meyer 运动功能量 表评价一致性检验 [J]. 辽宁中医杂志 , 2009, 36(11): 1827-1829. 

[8] 瓮长水 , 王军 , 潘小燕 , 等 . 上肢动作研究量表在脑卒中患者中 的效度 [J]. 中国康复理论与实践 , 2008, 14(1): 53-54. 

[9] 李军涛 , 王伊龙 , 于进洪 , 等 . 脑卒中专门化生存质量量表 (SSQOL) 中译本在冀南地区效度的研究 [J]. 脑与神经疾病杂志 , 2007, 15(3): 177-179. 

[10] 刘泉宏 , 高俊丽 , 郭学斌 , 等 . 六味地黄汤合八珍汤配合康复训 练治疗缺血性脑卒中恢复期疗效观察 [J]. 现代中西医结合杂志 , 2022, 31(16): 2273-2276. 

[11] HU C , WANG X , PAN T L.Effect of acupuncture combined with lower limb gait rehabilitation robot on improving walking function in stroke patients with hemiplegia[J].NeuroRehabilitation, 2024, 54(2): 309-317. 

[12] Hishikawa N , Sawada K , Maeda H , et al.One-Leg Robotic-assisted gait training efficiently improves gait independence for acute stroke hemiplegic patients[J].American Journal of Physical Medicine & Rehabilitation, 2024, 103(5): 444-447. 

[13] 丁晓晶 , 王勇军 , 姜云虎 , 等 . 等速肌力训练对脑卒中偏瘫患 者上肢身体成分的影响 [J]. 中国康复理论与实践 , 2022, 28(11): 1265-1269. 

[14] 姜林鸿 , 张广渊 , 齐瑞 , 等 . 等速肌力训练对脑卒中偏瘫患者下 肢运动功能康复效果的 meta 分析 [J]. 中国康复医学杂志 , 2023, 38(3): 388-393. 

[15] 李豫 , 朱琳 , 陈科容 , 等 . 下肢外骨骼机器人联合传统康复训练 对脑卒中患者步行功能恢复的疗效观察 [J]. 昆明医科大学学报 , 2024, 45(7): 92-98. 

[16] 安丹蔷 , 季宇宣 , 张瀚之 , 等 . 下肢康复训练机器人联合等速 肌力训练对老年脑卒中偏瘫患者神经功能、步行能力、Lovett 肌力分级及平衡能力的影响 [J]. 临床和实验医学杂志 , 2024, 23(4): 377-381. 

[17] 舒国建 , 刘家庆 , 向云 , 等 . 下肢康复机器人联合等速肌力训练 对脑卒中后下肢运动功能影响的临床对照研究 [J]. 中国康复 , 2020, 35(7): 339-342. 

[18] Holmgren D , Noory S , Moström E.Weaker quadriceps muscle strength with a quadriceps tendon graft compared with a patellar or hamstring tendon graft at 7 months after anterior cruciate ligament reconstruction[J]. American Journal of Sports Medicine, 2024, 52(1): 69-76. 

[19] XU G C, HUO C C, YIN J H, et al.Effective brain network analysis in unilateral and bilateral upper limb exercise training in subjects with stroke[J].Medical physics, 2022, 49(5): 3333-3346. 

[20] 唐泽文 , 许方军 , 秦成义 , 等 . 上肢康复机器人联合等速肌力训 练对脑卒中恢复期偏瘫患者的康复效果研究 [J]. 现代生物医学 进展 , 2023, 23(16): 3183-3186.