目的 系统评价Lokomat机器人辅助训练改善脑瘫患儿下肢功能的效果,为指导临床康复实践提供科学依据。方法 检索PubMed、Web of Science、Embase、Cochrane Library、中国知网、万方、维普和中国生物医学文献数据库中关于Lokomat机器人辅助训练对脑瘫患儿下肢功能影响的文献,检索时限为建库至2024年7月。两名研究者独立对数据库文献进行筛选、提取数据和偏倚风险评估,使用RevMan 5.4软件进行Meta分析。结果 最终纳入11项随机对照试验,涉及脑瘫样本量为502例。Meta 分析显示:试验组粗大运动功能评估量表(GMFM-88) D区评分(SMD=0.40,95%CI:0.06～0.74,P=0.02)、GMFM-88 E区评分(SMD=0.43,95%CI:0.07～0.79,P=0.02)、自由步行速度(MD=0.11,95%CI:0.06～0.16,P＜0.001)和BBS评分(MD=3.50,95%CI:1.27～5.74,P=0.002)明显优于对照组,两组间6min步行距离差异无统计学意义(P＞0.05)。结论 Lokomat机器人辅助步态训练可在一定程度上改善脑瘫患儿的下肢运动、步行和平衡能力,可作为一种安全有效的康复手段在临床应用。
Abstract
Objective To systematically evaluate the effectiveness of Lokomat robotic-assisted gait training in improving lower limb function in children with cerebral palsy, in order to provide a scientific basis for guiding clinical rehabilitation practice. Methods PubMed, Web of Science, Embase, Cochrane Library, CNKI, Wanfang Data, VIP, and China Biology Medicine(CBM) were searched for literature on the effect of Lokomat robotic-assisted gait training on lower limb function in children with cerebral palsy, with a retrieval period from the inception of the databases to July 2024. Two researchers independently screened the literature, extracted data, and assessed risk of bias. Meta-analysis was conducted using RevMan 5.4 software. Results A total of 11 randomized controlled trials were included, involving 502 patients with cerebral palsy. Meta-analysis showed that GMFM-88 D score(SMD=0.40, 95%CI:0.06 - 0.74, P=0.02), GMFM-88 E score(SMD=0.43, 95%CI:0.07 - 0.79, P=0.02), free walking speed(MD=0.11, 95%CI:0.06 - 0.16, P＜0.001), and BBS score(MD=3.50, 95%CI:1.27 - 5.74, P=0.002) were better in the experimental group than those in the control group. There was no significant difference in 6-minute walk distance between the two groups(P＞0.05). Conclusion Lokomat robotic-assisted gait training can improve lower limb motor function, walking ability, and balance in children with cerebral palsy to a certain extent, and may serve as a safe and effective rehabilitation method for chinical application.
关键词
脑性瘫痪 /
Lokomat /
机器人辅助训练 /
康复 /
Meta分析
Key words
cerebral palsy /
Lokomat /
robot-assisted training /
rehabilitation /
Meta-analysis
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基金
江苏省自然科学基金(BK20230292);江苏省卫生健康委医学科研项目(M2022022);淮安市科技局自然科学研究项目(HAB202333);淮安市科技计划项目(HAB202126)
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