深度烧伤后患者长期卧床,体位固定和创面愈合后瘢痕增生挛缩,往往会导致诸多肢体功能障碍, 尤其是下肢烧伤,其严重结果会影响患者行走,跳跃,站立等功能,极大地降低了患者的生活质量。目前运动疗法 在烧伤肢体的康复治疗中发挥重要作用,常用的方法包括关节活动度训练、牵伸训练、主动助力运动训练、抗阻训 练、水中运动训练等。上述方法施于患者肢体,对患肢进行活动锻炼,可改善患肢的功能障碍。随着科技的不断进 步,功能训练机器人应运而生,其出现节约了人力,提供给患者精细、程序化、标准化、可持续化的功能锻炼治疗, 其中步态辅助训练机器人在康复治疗中得到广泛应用。本文对机器人辅助步态训练在烧伤康复治疗中的优势、应用 及不足进行了综述,为其在烧伤康复治疗中的进一步应用提供参考依据。
Patients frequently experience long-term bedridden, body position fixation, scar hyperplasia and contracture following deep burns, which can result in limb dysfunction, particularly in the lower extremities. These complications significantly impact patients’ ability to walk, jump, stand, and perform other activities, thereby diminishing their quality of life. Exercise therapy is a crucial component of burned limb rehabilitation, commonly utilized techniques including joint range of motion training, stretching, active assistance exercise, resistance training, and water-based exercises, etc. The aforementioned techniques are utilized on the patient’s extremities for physical activity training aimed at enhancing the functionality of the impaired limbs. The advancement of technology has led to the development of functional training robots, which offer a more efficient and standardized approach to functional exercise therapy, reducing the need for human intervention. Gait assistance training robots, in particular, have become prevalent in rehabilitation practices. This article offers a comprehensive overview of the benefits, applications, and limitations of robot-assisted gait training in burn rehabilitation, which may serve as a valuable reference for the further implementation of this training method in burn rehabilitation.
收稿日期:2024-02-29 录用日期:2024-04-18
Received Date: 2024-02-29 Accepted Date: 2024-04-18
基金项目:国家自然科学基金(82272268)
Foundation Item: National Natural Science Foundation of China(82272268)
通讯作者:官浩,Email:guanhao2020@yeah.net
Corresponding Author: GUAN Hao, Email: guanhao2020@yeah.net
引用格式:张拔渤,赵海洋,张万福,等 . 机器人辅助步态训练在烧伤康复中的研究进展 [J]. 机器人外科学杂志(中英文),2024, 5(6):1167-1170,1224.
Citation: ZHANG B B, ZHAO H Y, ZHANG W F, et al. Research advances on robot-assisted gait training in burn rehabilitation[J]. Chinese Journal of Robotic Surgery, 2024, 5(6): 1167-1170, 1224.
[1] Bohannon, R.W, Crouch R. Minimal clinically important difference for change in 6-min walk test distance of adults with pathology: a asystematic review[J]. J Eval Clin Pract, 2017, 23(2): 377-381.
[2] Gawaziuk J P, Peters B, Logsetty S. Early ambulation after-grafting of lower extremity burns[J]. Burns, 2018, 44(1): 183-187.
[3] 中国老年医学学会烧创伤分会 . 烧伤后关节功能障碍的预防与 康复治疗专家共识 (2021 版 )[J]. 中华损伤与修复杂志 ( 电子版 ), 2021, 16(4): 277-282.
[4] Price K, Moiemen N, Nice L, et al. Patient experience of scar assessment and the use of scar assessment tools during burns rehabilitation: a qualitative study[J]. Burns Trauma, 2021. DOI: 10.1093/burnst/ tkab005.
[5] Yoshioka T, Kubota S, Sugaya H, et al. Robotic device-assisted knee extension training during the early postoperative period after opening wedge high tibial osteotomy: a case report[J]. J Med Case Rep, 2017, 11(1): 213.
[6] Kang M G, Yun S J, Shin H I, et al. Effects of robot-assisted gait training in patients with Parkinson’s disease: study protocol for a randomized controlled trial[J]. Trials, 2019, 20(1): 15.
[7] Lefmann S, Russo R, Hillier S. The effectiveness of robotic-assisted gait training for paediatric gait disorders: systematic review[J]. J Neuroeng Rehabil, 2017, 14(1): 1.
[8] Joo S Y, Lee S Y, Cho Y S, et al. Effectiveness of robot-assisted gait training on patients with burns: a preliminary study[J]. Comput Methods Biomech Biomed Engin, 2020, 23(12): 888-893.
[9] Morone G, Paolucci S, Cherubini A, et al. Robot-assisted gait training for stroke patients: current state of the art and perspectives of robotics[J]. Neuropsychiatr Dis Treat, 2017. DOI: 10.2147/NDT. S114102.
[10] Calabrò R S, Cacciola A, Bertè F, et al. Robotic gait rehabilitation and substitution devices in neurological disorders: where are we now?[J]. Neuropsychiatric Disease and Treatment, 2016, 37(4): 503-514.
[11] Schwartz I, Sajin A, Fisher I, et al. The effectiveness of locomotor therapy using robotic-assisted gait training in subacute stroke patients: a randomized controlled trial[J]. PM&R, 2009, 1(6): 516-523.
[12] Hidler J, Nichols D, Pelliccio M, et al. Multicenter randomized clinical trial evaluating the effectiveness of the Lokomat in subacute stroke[J]. Neurorehabilitation and Neural Repair, 2009, 23(1): 5-13.