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

Video：

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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, 王海军, 等. 长病程前交叉韧带损伤后膝关节继发改变研究. 中国运动医学杂志, 2019, 38(4): 276-280.
3.	张莉, 许建文, 黄浪, 等. 全身振动联合运动训练对前交叉韧带重建术后患者早期康复的影响. 中华物理医学与康复杂志, 2021, 43(2): 158-161.
4.	施明, 潘文平, 曾明, 等. 虚拟现实平衡训练对前交叉韧带重建术后步行能力的影响. 江苏医药, 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.	刘燕平, 陈美云. Lokomat 下肢康复机器人对改善帕金森病患者步行能力的疗效研究. 中国康复, 2017, 32(1): 30-32.
8.	曾鹏. 磁共振成像技术在膝关节前交叉韧带断裂诊断中的价值. 影像研究与医学应用, 2020, 4(5): 85-86.
9.	Green A, Hayda R, Andrew CH. AAOS 骨科术后康复. 王雪强, 王于领, 译. 北京: 北京科学技术出版社, 2021: 475-477.
10.	王伟, 李岩, 吴华, 等. 下肢康复机器人训练对急性脑卒中患者下肢运动功能的影响. 中华物理医学与康复杂志, 2013, 35(6): 464-467.
11.	韩东明, 万顺新, 易鑫明. 不同关节镜手术时机对膝关节前交叉韧带断裂及 Lysholm 评分影响. 西藏医药, 2020, 41(4): 59-60.
12.	王康玲, 黄杰斌, 吴文, 等. 一种便携式步态分析系统的信度研究. 中国康复医学杂志, 2016, 31(7): 761-764, 782.
13.	Cioppa-Mosca J, Cahill JB, Cavanaugh JT, et al. 骨科术后康复指南. 陆芸, 周谋望, 李世民, 等, 译. 天津: 天津科技翻译出版公司, 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, 陈现超. 本体感觉训练对前交叉韧带损伤重建术后患者运动功能的影响研究. 中国学校体育(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.	张磊, 李义凯. 膝关节前交叉韧带本体感觉的研究进展. 中国康复医学杂志, 2017, 32(2): 245-247.
20.	吕杰, 袁洁玲, 戈睿毅, 等. 前交叉韧带重建术后股四头肌萎缩的原因及康复策略. 中华关节外科杂志(电子版), 2020, 14(2): 206-211.
21.	程洪, 黄瑞, 邱静, 等. 康复机器人及其临床应用综述. 机器人, 2021, 43(5): 606-619.
22.	王颖. 基于中枢模式发生器的下肢功能性电刺激康复系统设计与应用. 上海: 上海交通大学, 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.	郑焕驰, 王俊华, 王程灵. 步行康复机器人综述. 按摩与康复医学, 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, 王海军, 等. 长病程前交叉韧带损伤后膝关节继发改变研究. 中国运动医学杂志, 2019, 38(4): 276-280.
3. 张莉, 许建文, 黄浪, 等. 全身振动联合运动训练对前交叉韧带重建术后患者早期康复的影响. 中华物理医学与康复杂志, 2021, 43(2): 158-161.
4. 施明, 潘文平, 曾明, 等. 虚拟现实平衡训练对前交叉韧带重建术后步行能力的影响. 江苏医药, 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. 刘燕平, 陈美云. Lokomat 下肢康复机器人对改善帕金森病患者步行能力的疗效研究. 中国康复, 2017, 32(1): 30-32.
8. 曾鹏. 磁共振成像技术在膝关节前交叉韧带断裂诊断中的价值. 影像研究与医学应用, 2020, 4(5): 85-86.
9. Green A, Hayda R, Andrew CH. AAOS 骨科术后康复. 王雪强, 王于领, 译. 北京: 北京科学技术出版社, 2021: 475-477.
10. 王伟, 李岩, 吴华, 等. 下肢康复机器人训练对急性脑卒中患者下肢运动功能的影响. 中华物理医学与康复杂志, 2013, 35(6): 464-467.
11. 韩东明, 万顺新, 易鑫明. 不同关节镜手术时机对膝关节前交叉韧带断裂及 Lysholm 评分影响. 西藏医药, 2020, 41(4): 59-60.
12. 王康玲, 黄杰斌, 吴文, 等. 一种便携式步态分析系统的信度研究. 中国康复医学杂志, 2016, 31(7): 761-764, 782.
13. Cioppa-Mosca J, Cahill JB, Cavanaugh JT, et al. 骨科术后康复指南. 陆芸, 周谋望, 李世民, 等, 译. 天津: 天津科技翻译出版公司, 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, 陈现超. 本体感觉训练对前交叉韧带损伤重建术后患者运动功能的影响研究. 中国学校体育(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. 张磊, 李义凯. 膝关节前交叉韧带本体感觉的研究进展. 中国康复医学杂志, 2017, 32(2): 245-247.
20. 吕杰, 袁洁玲, 戈睿毅, 等. 前交叉韧带重建术后股四头肌萎缩的原因及康复策略. 中华关节外科杂志(电子版), 2020, 14(2): 206-211.
21. 程洪, 黄瑞, 邱静, 等. 康复机器人及其临床应用综述. 机器人, 2021, 43(5): 606-619.
22. 王颖. 基于中枢模式发生器的下肢功能性电刺激康复系统设计与应用. 上海: 上海交通大学, 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. 郑焕驰, 王俊华, 王程灵. 步行康复机器人综述. 按摩与康复医学, 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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