Effect of lower limb rehabilitation robot combined with virtual reality training on walking ability after anterior cruciate ligament reconstruction_West China Medical Journal

Authors：

LIN Zailong ,  GU Xudong , FU Jianming , YAO Yunhai , WU Hua , LI Hui , LI Yan , SHI Ming , SUN Ya , BAI Hefeng

Rehabilitation Medical Center, the Second Hospital of Jiaxing, Jiaxing, Zhejiang 314000, P. R. China;

Corresponding?author：

GU Xudong, Email: jxgxd@hotmail.com

Keywords：

Anterior cruciate ligament; lower limb rehabilitation robot; virtual reality; walking ability

DOI：

10.7507/1002-0179.202203051

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Objective To investigate the effect of lower limb rehabilitation robot combined with virtual reality training on walking ability after anterior cruciate ligament reconstruction (ACLR). Methods Patients after ACLR treated in the Rehabilitation Medical Center of the Second Hospital of Jiaxing between May 2019 and July 2021 were selected. The patients were randomly divided into two groups. The patients with conventional ACLR rehabilitation training + lower limb rehabilitation robot combined with virtual reality training were used as the treatment group, and only the patients with conventional ACLR rehabilitation training were used as the control group. The rehabilitation training lasted for 8 weeks. After 4 and 8 weeks of treatment, the two groups were evaluated by Lysholm knee score scale (LKSS), Holden walking score and Gait watch gait analysis. Results A total of 40 patients were included, with 20 patients in each group. There was no significant difference between the two groups in LKSS score, Holden walking score and Gait watch gait analysis dynamic data at 4 weeks of treatment (P>0.05). After 8 weeks of treatment, the LKSS score [(77.74±5.53) vs. (69.53±5.26) points], Holden walking score [(4.79±0.34) vs. (4.45±0.39) points] and Gait watch gait analysis dynamic data [step size: (78.35±2.43) vs. (73.64±3.35) cm, step frequency: (115.10±4.49) vs. (107.71±5.14) step/min, step speed: (108.63±8.55) vs. (96.78±8.47) cm/s] of the treatment group were better than those of the control group (P<0.05), The above indexes of the two groups were improved compared with those at 4 weeks of treatment (P<0.05). Conclusion Lower limb rehabilitation robot combined with virtual reality training can effectively improve walking ability after ACLR.

Citation： LIN Zailong, GU Xudong, FU Jianming, YAO Yunhai, WU Hua, LI Hui, LI Yan, SHI Ming, SUN Ya, BAI Hefeng. Effect of lower limb rehabilitation robot combined with virtual reality training on walking ability after anterior cruciate ligament reconstruction. West China Medical Journal, 2022, 37(5): 717-721. doi: 10.7507/1002-0179.202203051 Copy

1.	Beard DJ, Dodd CA, Trundle HR, et al. Proprioception enhancement for anterior cruciate ligament deficiency. A prospective randomised trial of two physiotherapy regimes. J Bone Joint Surg Br, 1994, 76(4): 654-659.
2.	王健, 王永健, 王海軍, 等. 長病程前交叉韌帶損傷后膝關節繼發改變研究. 中國運動醫學雜志, 2019, 38(4): 276-280.
3.	張莉, 許建文, 黃浪, 等. 全身振動聯合運動訓練對前交叉韌帶重建術后患者早期康復的影響. 中華物理醫學與康復雜志, 2021, 43(2): 158-161.
4.	施明, 潘文平, 曾明, 等. 虛擬現實平衡訓練對前交叉韌帶重建術后步行能力的影響. 江蘇醫藥, 2021, 47(2): 129-132.
5.	Weng CJ, Yeh WL, Hsu KY, et al. Clinical and functional outcomes of anterior cruciate ligament reconstruction with autologous hamstring tendon in patients aged 50 years or older. Arthroscopy, 2020, 36(2): 558-562.
6.	Perez JR, Emerson CP, Barrera CM, et al. Patient-reported knee outcome scores with soft tissue quadriceps tendon autograft are similar to bone-patellar tendon-bone autograft at minimum 2-year folow-up: aretrospective single-center cohort study in primary anterior cruciate igament reconstruction surgery. Orthop J Sports Med, 2019, 7(12): 2325967119890063.
7.	劉燕平, 陳美云. Lokomat 下肢康復機器人對改善帕金森病患者步行能力的療效研究. 中國康復, 2017, 32(1): 30-32.
8.	曾鵬. 磁共振成像技術在膝關節前交叉韌帶斷裂診斷中的價值. 影像研究與醫學應用, 2020, 4(5): 85-86.
9.	Green A, Hayda R, Andrew CH. AAOS 骨科術后康復. 王雪強, 王于領, 譯. 北京: 北京科學技術出版社, 2021: 475-477.
10.	王偉, 李巖, 吳華, 等. 下肢康復機器人訓練對急性腦卒中患者下肢運動功能的影響. 中華物理醫學與康復雜志, 2013, 35(6): 464-467.
11.	韓東明, 萬順新, 易鑫明. 不同關節鏡手術時機對膝關節前交叉韌帶斷裂及 Lysholm 評分影響. 西藏醫藥, 2020, 41(4): 59-60.
12.	王康玲, 黃杰斌, 吳文, 等. 一種便攜式步態分析系統的信度研究. 中國康復醫學雜志, 2016, 31(7): 761-764, 782.
13.	Cioppa-Mosca J, Cahill JB, Cavanaugh JT, et al. 骨科術后康復指南. 陸蕓, 周謀望, 李世民, 等, 譯. 天津: 天津科技翻譯出版公司, 2009: 418-423.
14.	Palmieri-Smith RM, Lepley LK. Quadriceps strength asymmetry after anterior clciate ligament reconstruction alters knee joint biomechanics and functional performance at time of return to activity. Am J Sports Med, 2015, 43(7): 1662-1669.
15.	付常喜, 陳現超. 本體感覺訓練對前交叉韌帶損傷重建術后患者運動功能的影響研究. 中國學校體育(高等教育), 2017, 4(7): 82-86.
16.	Lephart SM, Henry TJ. The physiological basis for open and closed kinetic chain rehabilitation for the upper extremity. J Sport Rehab, 1996, 5(1): 71-87.
17.	MacDonald PB, Hedden D, Pacin O, et al. Proprioception in anterior crciate ligament deficient und reconstructed knees. Am J Sports Med, 1996, 24(6): 774-778.
18.	Donnell-Fink LA, Klara K, Collins JE, et al. Effectiveness of knee injury and anterior cruciate ligament tear prevention programs: a meta-analysis. PLoS One, 2015, 10(12): e0144063.
19.	張磊, 李義凱. 膝關節前交叉韌帶本體感覺的研究進展. 中國康復醫學雜志, 2017, 32(2): 245-247.
20.	呂杰, 袁潔玲, 戈睿毅, 等. 前交叉韌帶重建術后股四頭肌萎縮的原因及康復策略. 中華關節外科雜志(電子版), 2020, 14(2): 206-211.
21.	程洪, 黃瑞, 邱靜, 等. 康復機器人及其臨床應用綜述. 機器人, 2021, 43(5): 606-619.
22.	王穎. 基于中樞模式發生器的下肢功能性電刺激康復系統設計與應用. 上海: 上海交通大學, 2012.
23.	Culvenor AG, Colins NJ, Vicenzino B, et al. Predictors and effects of patelofemoral pain following hamstring-tendon ACL reconstruction. J Sci Med Sport, 2016, 19(7): 518-523.
24.	鄭煥馳, 王俊華, 王程靈. 步行康復機器人綜述. 按摩與康復醫學, 2019(20): 1-5.

1. Beard DJ, Dodd CA, Trundle HR, et al. Proprioception enhancement for anterior cruciate ligament deficiency. A prospective randomised trial of two physiotherapy regimes. J Bone Joint Surg Br, 1994, 76(4): 654-659.
2. 王健, 王永健, 王海軍, 等. 長病程前交叉韌帶損傷后膝關節繼發改變研究. 中國運動醫學雜志, 2019, 38(4): 276-280.
3. 張莉, 許建文, 黃浪, 等. 全身振動聯合運動訓練對前交叉韌帶重建術后患者早期康復的影響. 中華物理醫學與康復雜志, 2021, 43(2): 158-161.
4. 施明, 潘文平, 曾明, 等. 虛擬現實平衡訓練對前交叉韌帶重建術后步行能力的影響. 江蘇醫藥, 2021, 47(2): 129-132.
5. Weng CJ, Yeh WL, Hsu KY, et al. Clinical and functional outcomes of anterior cruciate ligament reconstruction with autologous hamstring tendon in patients aged 50 years or older. Arthroscopy, 2020, 36(2): 558-562.
6. Perez JR, Emerson CP, Barrera CM, et al. Patient-reported knee outcome scores with soft tissue quadriceps tendon autograft are similar to bone-patellar tendon-bone autograft at minimum 2-year folow-up: aretrospective single-center cohort study in primary anterior cruciate igament reconstruction surgery. Orthop J Sports Med, 2019, 7(12): 2325967119890063.
7. 劉燕平, 陳美云. Lokomat 下肢康復機器人對改善帕金森病患者步行能力的療效研究. 中國康復, 2017, 32(1): 30-32.
8. 曾鵬. 磁共振成像技術在膝關節前交叉韌帶斷裂診斷中的價值. 影像研究與醫學應用, 2020, 4(5): 85-86.
9. Green A, Hayda R, Andrew CH. AAOS 骨科術后康復. 王雪強, 王于領, 譯. 北京: 北京科學技術出版社, 2021: 475-477.
10. 王偉, 李巖, 吳華, 等. 下肢康復機器人訓練對急性腦卒中患者下肢運動功能的影響. 中華物理醫學與康復雜志, 2013, 35(6): 464-467.
11. 韓東明, 萬順新, 易鑫明. 不同關節鏡手術時機對膝關節前交叉韌帶斷裂及 Lysholm 評分影響. 西藏醫藥, 2020, 41(4): 59-60.
12. 王康玲, 黃杰斌, 吳文, 等. 一種便攜式步態分析系統的信度研究. 中國康復醫學雜志, 2016, 31(7): 761-764, 782.
13. Cioppa-Mosca J, Cahill JB, Cavanaugh JT, et al. 骨科術后康復指南. 陸蕓, 周謀望, 李世民, 等, 譯. 天津: 天津科技翻譯出版公司, 2009: 418-423.
14. Palmieri-Smith RM, Lepley LK. Quadriceps strength asymmetry after anterior clciate ligament reconstruction alters knee joint biomechanics and functional performance at time of return to activity. Am J Sports Med, 2015, 43(7): 1662-1669.
15. 付常喜, 陳現超. 本體感覺訓練對前交叉韌帶損傷重建術后患者運動功能的影響研究. 中國學校體育(高等教育), 2017, 4(7): 82-86.
16. Lephart SM, Henry TJ. The physiological basis for open and closed kinetic chain rehabilitation for the upper extremity. J Sport Rehab, 1996, 5(1): 71-87.
17. MacDonald PB, Hedden D, Pacin O, et al. Proprioception in anterior crciate ligament deficient und reconstructed knees. Am J Sports Med, 1996, 24(6): 774-778.
18. Donnell-Fink LA, Klara K, Collins JE, et al. Effectiveness of knee injury and anterior cruciate ligament tear prevention programs: a meta-analysis. PLoS One, 2015, 10(12): e0144063.
19. 張磊, 李義凱. 膝關節前交叉韌帶本體感覺的研究進展. 中國康復醫學雜志, 2017, 32(2): 245-247.
20. 呂杰, 袁潔玲, 戈睿毅, 等. 前交叉韌帶重建術后股四頭肌萎縮的原因及康復策略. 中華關節外科雜志(電子版), 2020, 14(2): 206-211.
21. 程洪, 黃瑞, 邱靜, 等. 康復機器人及其臨床應用綜述. 機器人, 2021, 43(5): 606-619.
22. 王穎. 基于中樞模式發生器的下肢功能性電刺激康復系統設計與應用. 上海: 上海交通大學, 2012.
23. Culvenor AG, Colins NJ, Vicenzino B, et al. Predictors and effects of patelofemoral pain following hamstring-tendon ACL reconstruction. J Sci Med Sport, 2016, 19(7): 518-523.
24. 鄭煥馳, 王俊華, 王程靈. 步行康復機器人綜述. 按摩與康復醫學, 2019(20): 1-5.

West China Medical Journal

Effect of lower limb rehabilitation robot combined with virtual reality training on walking ability after anterior cruciate ligament reconstruction

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