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Labari na Bincike: Tsarin Horon Gait na Taimakon Robot ga Marasa lafiya a Lokacin Farfaɗo Bayan bugun jini

Labarin Bincike

Shirin Horon Gait na Taimakon Robot don Marasa lafiya a Bugawa

Lokacin farfadowa: Gwajin Sarrafa Makafi Guda Guda

Deng Yu, Zhang Yang, Liu Lei, Ni Chaoming, da Wu Ming

Asibitin Farko mai alaƙa na USTC, Sashen Kimiyyar Rayuwa da Magunguna, Jami'ar Kimiyya da Fasaha ta China, Hefei, Anhui 230001, China

Correspondence should be addressed to Wu Ming; wumingkf@ustc.edu.cn

An karɓa 7 Afrilu 2021;An sabunta 22 Yuli 2021;An karɓa 17 ga Agusta 2021;An buga 29 ga Agusta 2021

Editan Ilimi: Ping Zhou

Haƙƙin mallaka © 2021 Deng Yu et al.Wannan labarin buɗaɗɗen shiga ne wanda aka rarraba ƙarƙashin lasisin Haɓaka Haɗin Kan Halitta, wanda ke ba da izinin amfani mara iyaka, rarrabawa, da haifuwa ta kowace matsakaici, in dai an ambaci ainihin aikin da kyau.

Fage.Rashin aikin tafiya yana wanzuwa a yawancin marasa lafiya bayan bugun jini.Shaida game da horar da tafiya a cikin makonni biyu ba ta da yawa a cikin iyakantattun saitunan albarkatu;An gudanar da wannan binciken don bincika sakamakon wani ɗan gajeren lokaci na ɗan gajeren lokaci na taimakon gait ga marasa lafiya da ke fama da bugun jini.Hanyoyin.An ba da marasa lafiya 85 bazuwar zuwa ɗayan ƙungiyoyin jiyya guda biyu, tare da marasa lafiya 31 a cikin janyewa kafin magani.Shirin horon ya ƙunshi zaman sa'o'i 14 na sa'o'i 2, na makonni 2 a jere.Marasa lafiya da aka keɓe ga ƙungiyar horon gait da ke taimaka wa robot ta amfani da Tsarin Koyarwa da Tsarin A3 na Gait daga NX (Rukunin RT, n = 27).An ba da wani rukuni na marasa lafiya zuwa ƙungiyar horar da gait na al'ada (PT group, n = 27).An ƙididdige ma'auni na sakamako ta amfani da nazarin gait na lokaci-space, Assessment Fugl-Meyer (FMA), da Timed Up and Go test (TUG).SakamakoA cikin nazarin ma'auni na lokaci-lokaci na gait, ƙungiyoyin biyu ba su nuna wani gagarumin canje-canje a cikin sigogi na lokaci ba, amma ƙungiyar RT ta nuna tasiri mai mahimmanci akan canje-canje a cikin sigogi na sararin samaniya (tsawon tsayi, saurin tafiya, da ƙafar ƙafa, P <0: 05).Bayan horarwa, maki FMA (20: 22 ± 2: 68) na ƙungiyar PT da maki FMA (25: 89 ± 4: 6) na ƙungiyar RT sun kasance masu mahimmanci.A cikin gwajin Timed Up da Go, ƙimar FMA na ƙungiyar PT (22: 43 ± 3: 95) sun kasance masu mahimmanci, yayin da waɗanda ke cikin rukunin RT (21: 31 ± 4: 92) ba su kasance ba.Kwatanta tsakanin ƙungiyoyi bai nuna wani bambance-bambance ba.

Kammalawa.Dukansu ƙungiyar RT da ƙungiyar PT na iya haɓaka iyawar tafiya na marasa lafiya a cikin makonni 2.

1. Gabatarwa

Shanyewar jiki shine babban dalilin nakasa.Nazarin da suka gabata sun ba da rahoton cewa, watanni 3 bayan farawa, kashi ɗaya bisa uku na marasa lafiya da suka tsira sun kasance masu dogaro da keken hannu kuma saurin tafiya da juriya sun ragu sosai a cikin kusan 80% na marasa lafiya na asibiti [1-3].Don haka, don taimakawa marasa lafiya komawa cikin al'umma na gaba, maido da aikin tafiya shine babban makasudin gyarawa da wuri [4].

Ya zuwa yau, mafi inganci zaɓuɓɓukan magani (yawanci da tsawon lokaci) don inganta tafiya da wuri bayan bugun jini, da kuma ingantaccen ci gaba da tsawon lokaci, har yanzu shine batun muhawara [5].A gefe guda, an lura cewa maimaita takamaiman hanyoyin takamaiman aiki tare da ƙarfin tafiya mai girma na iya haifar da haɓaka mafi girma a cikin tafiyar marasa lafiya na bugun jini [6].Musamman, an ba da rahoton cewa mutanen da suka sami haɗin gwiwar horo na motsa jiki na lantarki da motsa jiki bayan bugun jini sun nuna ci gaba fiye da waɗanda suka sami horo na yau da kullum, musamman a cikin watanni 3 na farko bayan bugun jini, kuma sun fi dacewa su sami 'yancin kai. tafiya [7].A gefe guda, ga mahalarta bugun jini tare da matsakaita zuwa matsananciyar matsalar gait, ana ba da rahoton nau'ikan ayyukan horon gait na yau da kullun sun fi tasiri fiye da horon gait na taimakon robot [8, 9].Bugu da ƙari, akwai shaidar cewa za a inganta aikin gait ba tare da la'akari da ko horon tafiya yana amfani da horon gait na mutum-mutumi ko motsa jiki na ƙasa [10].

Tun daga karshen shekarar 2019, bisa manufofin inshorar likitancin gida da na gida na kasar Sin, a mafi yawan sassan kasar Sin, idan aka yi amfani da inshorar likitanci wajen biyan kudaden da ake kashewa a asibiti, masu fama da shanyewar jiki za su iya kwantar da su har na tsawon makonni 2 kawai.Saboda an rage zaman asibiti na mako 4 na al'ada zuwa makonni 2, yana da mahimmanci don inganta ingantaccen hanyoyin gyaran gyare-gyare masu inganci ga marasa lafiya na bugun jini na farko.Don bincika wannan batu, mun kwatanta tasirin shirin jiyya na farko wanda ya ƙunshi horon gait na mutum-mutumi (RT) tare da horo na gait na ƙasa na al'ada (PT) don tantance tsarin kulawa mafi fa'ida don haɓaka gait.

 

2. Hanyoyi

2.1.Tsarin Karatu.Wannan shi ne na tsakiya guda ɗaya, makafi ɗaya, gwajin sarrafawa bazuwar.An amince da binciken daga Asibitin Farko na Jami'ar Kimiyya da

Fasaha na kasar Sin (IRB, Hukumar Bita na Cibiyar) (La'a. 2020-KY627).Sharuɗɗan haɗawa sun kasance kamar haka: bugun jini na farko na tsakiyar kwakwalwa (wanda aka rubuta ta hanyar na'urar daukar hoto ta kwamfuta ko hoton maganadisu);lokaci daga bugun jini na kasa da makonni 12;Mataki na Brunnstrom na ƙananan ƙananan aiki wanda ya kasance daga mataki na III zuwa mataki na IV;Ƙididdigar Ƙwararrun Ƙwararru na Montreal (MoCA) maki ≥ 26 maki, iya yin aiki tare tare da kammala horo na farfadowa da kuma iya bayyana ra'ayoyin game da horon [11];shekaru 35-75, namiji ko mace;da yarjejeniya don shiga cikin gwaji na asibiti, ba da izini a rubuce.

Sharuɗɗan keɓancewa sune kamar haka: harin ischemic na wucin gadi;raunin kwakwalwa da suka gabata, ba tare da la'akari da ilimin etiology ba;kasancewar rashin kulawa da aka kimanta ta amfani da Gwajin Ƙarrawa (bambanci na biyar na 35 karrarawa da aka tsallake tsakanin dama da hagu yana nuna rashin kulawar hemispatial) [12, 13];aphasia;nazarin jijiyoyi don tantance kasancewar rashin lafiyar somatosensory na asibiti;matsanancin spasticity da ke shafar ƙananan gaɓoɓin (gyaran ma'aunin Ashworth wanda ya fi 2);jarrabawar asibiti don tantance kasancewar ƙananan motsin motsi na apraxia (tare da kurakuran motsi na nau'in motsi na jiki wanda aka rarraba ta amfani da ma'auni masu zuwa: ƙungiyoyi masu banƙyama a cikin rashin motsi na asali da rashin ƙarfi na hankali, ataxia, da ƙwayar tsoka na al'ada);rabuwar kai tsaye ta atomatik;ƙananan skeletal skeletal bambancin, nakasawa, nakasassu na jiki, da kuma nakasar haɗin gwiwa tare da daban-daban dalilai;kamuwa da cutar fata na gida ko lalacewa a ƙasa da haɗin gwiwar hip na ƙananan ƙafa;marasa lafiya da ciwon farfadiya, wanda ba a kula da yanayin su yadda ya kamata ba;hade da wasu cututtuka masu tsanani na tsarin jiki, irin su mummunan aiki na zuciya;shiga cikin wasu gwaje-gwaje na asibiti a cikin wata 1 kafin gwajin;da kuma rashin sanya hannu kan yarda da aka sani.Dukkanin darussa sun kasance masu aikin sa kai, kuma dukkansu sun ba da izini a rubuce don shiga cikin binciken, wanda aka gudanar bisa ga sanarwar Helsinki, kuma kwamitin da'a na asibitin farko da ke da alaƙa da jami'ar kimiyya da fasaha ta kasar Sin ya amince da shi.

Kafin gwajin, mun sanya mahalarta da suka cancanta zuwa ƙungiyoyi biyu ba da gangan ba.Mun sanya majiyyata zuwa ɗayan ƙungiyoyin jiyya guda biyu bisa ƙayyadaddun tsarin bazuwar da software ta haifar.Masu binciken da suka ƙayyade ko majiyyaci ya cancanci haɗawa a cikin gwajin ba su san wane rukuni (ayyukan ɓoye) da za a sanya majiyyaci ba yayin yanke shawararsu.Wani mai binciken ya duba daidai rabon marasa lafiya bisa ga tebur bazuwar.Bayan jiyya da aka haɗa a cikin ƙa'idar binciken, ƙungiyoyin marasa lafiya biyu sun karɓi sa'o'i 0.5 na aikin motsa jiki na al'ada kowace rana, kuma babu wani nau'in gyara da aka yi.

2.1.1.Rukunin RT.Marasa lafiya da aka ba wa wannan rukunin sun sami horon motsa jiki ta hanyar tsarin horo da kimantawa na Gait A3 (NX, China), wanda ke motsa jikin mutum-mutumi na injin lantarki wanda ke ba da horon gait mai maimaitawa, mai ƙarfi, da takamaiman aiki.An gudanar da horarwar motsa jiki ta atomatik akan injin tuƙi.Marasa lafiya waɗanda ba su shiga cikin ƙima ba sun sami kulawar kulawa tare da daidaitawar saurin motsi da tallafin nauyi.Wannan tsarin ya ƙunshi tsarin asara mai ƙarfi da tsayin daka, wanda zai iya kwatanta ainihin tsakiyar canje-canjen nauyi yayin tafiya.Yayin da ayyuka ke inganta, matakan goyon baya na nauyi, gudunmawar ƙafar ƙafa, da ƙarfin jagoranci duk an daidaita su don kula da raunin rauni na tsokoki na gwiwa yayin matsayi na tsaye.Matsayin tallafi na nauyi yana raguwa a hankali daga 50% zuwa 0%, kuma ana rage ƙarfin jagora daga 100% zuwa 10% (ta hanyar rage ƙarfin jagora, wanda ake amfani da shi a duka matakan tsaye da juyawa, ana tilasta mai haƙuri yayi amfani da shi. tsokoki na hip da gwiwa don shiga cikin himma a cikin tsarin gait) [14, 15].Bugu da ƙari, bisa ga haƙuri na kowane majiyyaci, saurin gudu (daga 1.2 km / h) ya karu da 0.2 zuwa 0.4 km / h a kowace hanya na jiyya, har zuwa 2.6 km / h.Tasirin tsawon lokaci na kowane RT shine mintuna 50.

2.1.2.Rukunin PT.Horon gait na al'ada na al'ada ya dogara ne akan dabarun jiyya na ci gaba na al'ada.Wannan maganin ya haɗa da yin ma'auni na tsaye, canja wuri mai aiki, tsaye-tsaye, da horo mai zurfi ga marasa lafiya da ke fama da rashin lafiya.Tare da haɓaka aikin jiki, horar da marasa lafiya ya ƙara ƙaruwa cikin wahala, gami da horar da ma'auni mai ƙarfi, a ƙarshe yana haɓaka zuwa horon gait na aiki, yayin ci gaba da aiwatar da horo mai zurfi [16].

An ba da marasa lafiya zuwa wannan rukuni don horar da ƙasa (lokacin da ya dace na minti 50 a kowane darasi), da nufin inganta yanayin da ake ciki a lokacin tafiya, canja wurin nauyi, matsayi na tsaye, kwanciyar hankali na lokaci na kyauta, cikakken hulɗar diddige, da yanayin gait.Kwararren mai horarwa guda ɗaya ya kula da duk marasa lafiya a cikin wannan rukuni kuma ya daidaita aikin kowane motsa jiki bisa ga basirar mai haƙuri (watau ikon shiga cikin ci gaba da ci gaba da aiki yayin tafiya) da ƙarfin haƙuri, kamar yadda aka bayyana a baya ga ƙungiyar RT.

2.2.Hanyoyin.Dukkan mahalarta sunyi shirin horo wanda ya ƙunshi darasi na sa'o'i 2 (ciki har da lokacin hutu) kowace rana don kwanaki 14 a jere.Kowane zaman horo ya ƙunshi lokutan horo na minti 50, tare da lokacin hutu na minti 20 a tsakanin su.An kimanta marasa lafiya a asali kuma bayan mako 1 da makonni 2 (makon farko na ƙarshe).Mai ƙididdigewa ɗaya ba shi da masaniya game da aikin ƙungiyar kuma ya kimanta duk marasa lafiya.Mun gwada ingancin tsarin makanta ta hanyar tambayar mai kimantawa don yin hasashen ilimi.

2.3.Sakamako.Babban sakamakon shine maki FMA da gwajin TUG kafin da bayan horo.An kuma gudanar da nazarin ma'aunin ma'aunin lokaci-lokaci ta amfani da tsarin tantance ma'auni (samfurin: AL-080, Anhui Aili Intelligent Technology Co, Anhui, China) [17], gami da lokacin tafiya (s), lokacin lokaci guda ɗaya (s) , Biyu stance lokaci lokaci (s), lilo lokaci lokaci (s), stance lokaci lokaci (s), tsayin tsayin (cm), saurin tafiya (m/s), cadence (matakai/min), faɗin gait (cm), kuma yatsa daga kusurwa (deg).

A cikin wannan binciken, ana iya amfani da ma'auni tsakanin ma'aunin sararin samaniya/lokaci don a sauƙaƙe gano matakin daidaitawa tsakanin ɓangaren da abin ya shafa da kuma ɓangaren da ba ya shafa.Ƙididdigar ma'auni da aka samo daga ma'auni kamar haka [18]:

Lokacin da gefen da abin ya shafa ya kasance mai ma'ana zuwa gefen da ba a shafa ba, sakamakon ma'auni shine 1. Lokacin da ma'auni ya fi 1 girma, rarraba ma'auni daidai da gefen da abin ya shafa yana da girma.Lokacin da ma'aunin ma'auni bai wuce 1 ba, rabon siga wanda ya yi daidai da gefen da ba ya shafa ya fi girma.

2.4.Binciken Kididdiga.An yi amfani da software na ƙididdigar ƙididdiga na SPSS 18.0 don nazarin bayanan.An yi amfani da gwajin KolmogorovSmirnov don tantance zato na al'ada.An gwada halayen mahalarta a cikin kowane rukuni ta amfani da gwajin t-tes masu zaman kansu don masu canji na yau da kullun da kuma gwajin Mann-Whitney U don masu canji marasa daidaituwa.An yi amfani da gwajin matsayi na Wilcoxon don kwatanta canje-canje kafin da kuma bayan jiyya tsakanin ƙungiyoyin biyu.An yi la'akari da ƙimar P <0.05 don nuna mahimmancin ƙididdiga.

3. Sakamako

Daga Afrilu 2020 zuwa Disamba 2020, jimlar masu sa kai 85 waɗanda suka cika ka'idodin cancanta tare da bugun jini na yau da kullun sun sanya hannu don shiga gwajin.An ba su bazuwar zuwa ƙungiyar PT (n = 40) da ƙungiyar RT (n = 45).Marasa lafiya na 31 ba su sami shiga tsakani da aka ba su ba (janyewa kafin magani) kuma ba za a iya bi da su ba saboda wasu dalilai na sirri da iyakancewar yanayin gwajin asibiti.A ƙarshe, mahalarta 54 waɗanda suka cika ka'idodin cancanta sun shiga cikin horo (kungiyar PT, n = 27; RT rukuni, n = 27).An nuna ginshiƙi mai gauraya wanda ke nuna ƙirar bincike a hoto na 1. Ba a ba da rahoton wani mummunan aukuwa ko manyan haɗari ba.

3.1.Baseline.A ƙididdigar asali, ba a sami bambance-bambance masu mahimmanci tsakanin ƙungiyoyin biyu dangane da shekaru (P = 0: 14), lokacin fara bugun jini (P = 0: 47), maki FMA (P = 0: 06), da maki TUG. (P = 0:17).Ana nuna alamun alƙaluma da halayen asibiti na marasa lafiya a cikin Tables 1 da 2.

3.2.Sakamako.Don haka, nazarin ƙarshe ya haɗa da marasa lafiya 54: 27 a cikin ƙungiyar RT da 27 a cikin ƙungiyar PT.Shekaru, makonni bayan bugun jini, jima'i, gefen bugun jini, da nau'in bugun jini ba su bambanta sosai tsakanin ƙungiyoyin biyu ba (duba Table 1).Mun auna ci gaba ta hanyar ƙididdige bambanci tsakanin makin tushe da maki 2 na kowane rukuni.Saboda ba a rarraba bayanai akai-akai, an yi amfani da gwajin Mann–Whitney U don kwatanta ma'auni na asali da bayan horo tsakanin ƙungiyoyin biyu.Babu bambance-bambance masu mahimmanci tsakanin ƙungiyoyi a cikin kowane ma'aunin sakamako kafin magani.

Bayan zaman horo na 14, ƙungiyoyin biyu sun nuna ci gaba mai mahimmanci a cikin akalla ma'aunin sakamako.Bugu da ƙari, ƙungiyar PT ta nuna ingantaccen ingantaccen aiki (duba Table 2).Game da maki FMA da TUG, kwatanta maki kafin da bayan 2 makonni na horo ya nuna bambance-bambance masu mahimmanci a cikin ƙungiyar PT (P <0: 01) (duba Table 2) da bambance-bambance masu mahimmanci a cikin ƙungiyar RT (FMA, P = 0: 02), amma sakamakon TUG (P = 0:28) bai nuna wani bambanci ba.Kwatancen tsakanin ƙungiyoyi ya nuna cewa babu wani babban bambanci tsakanin ƙungiyoyin biyu a cikin maki FMA (P = 0:26) ko maki TUG (P = 0:97).

Game da ƙididdigar gait na lokaci, a cikin kwatancen intragroup, babu wasu bambance-bambance masu mahimmanci kafin da kuma bayan kowane ɓangaren ƙungiyoyin biyu da suka shafi gefen (P> 0:05).A cikin kwatankwacin rukuni-rukuni na lokacin jujjuyawar juna, ƙungiyar RT tana da mahimmancin ƙididdiga (P = 0:01).A cikin ma'auni na ɓangarorin biyu na ƙananan gaɓoɓin kafin da kuma bayan makonni biyu na horo a cikin lokacin tsayawa da lokacin lilo, ƙungiyar RT ta kasance mai mahimmanci a cikin bincike na intragroup (P = 0: 04).Bugu da ƙari, lokaci na matsayi, lokacin juyawa, da daidaituwa na ɓangaren da ba a shafa ba da kuma ɓangaren da aka shafa ba su da mahimmanci a tsakanin ƙungiyoyi (P> 0: 05) (duba Hoto 2).

Game da nazarin gait na sararin samaniya, kafin da kuma bayan makonni 2 na horo, an sami babban bambanci a fadin gait a gefen da abin ya shafa (P = 0: 02) a cikin ƙungiyar PT.A cikin rukunin RT, ɓangaren da abin ya shafa ya nuna bambance-bambance masu mahimmanci a cikin saurin tafiya (P = 0:03), kusurwar yatsan hannu (P = 0:01), da tsayin tafiya (P = 0:03).Duk da haka, bayan kwanaki 14 na horo, ƙungiyoyin biyu ba su nuna wani gagarumin ci gaba ba a cikin kwarewa.Sai dai babban bambancin ƙididdiga a kusurwar yatsan ƙafa (P = 0:002), ba a sami bambance-bambance masu mahimmanci a kwatanta tsakanin ƙungiyoyi ba.

4. Tattaunawa

Babban maƙasudin wannan gwajin da aka sarrafa bazuwar shine a kwatanta tasirin horon gait mai taimaka wa mutum-mutumi (Rukunin RT) da horon gait na al'ada (ƙungiyar PT) don masu fama da bugun jini na farko tare da matsalar gait.Binciken na yanzu ya nuna cewa, idan aka kwatanta da horar da gait na al'ada (PT group), horar da gait tare da robot A3 ta amfani da NX yana da fa'idodi da yawa don inganta aikin mota.

Yawancin binciken da aka yi a baya sun ba da rahoton cewa horon gait na mutum-mutumi tare da jiyya na jiki bayan bugun jini ya karu da yiwuwar samun tafiya mai zaman kansa idan aka kwatanta da horar da motsa jiki ba tare da waɗannan na'urori ba, kuma mutanen da suka sami wannan shiga cikin watanni 2 na farko bayan bugun jini da kuma wadanda ba su iya tafiya ba an samu. don ya fi amfana [19, 20].Hasashenmu na farko shi ne cewa mutum-mutumi da aka taimaka horar da gait zai kasance mafi inganci fiye da horar da ƙwallon ƙafa na gargajiya wajen inganta ƙarfin motsa jiki, ta hanyar samar da ingantattun tsarin tafiya mai ma'ana don daidaita tafiyar marasa lafiya.Bugu da ƙari, mun annabta cewa farkon horo na taimakon robot bayan bugun jini (watau ƙayyadaddun ƙa'idodi daga tsarin asarar nauyi, daidaitaccen lokaci na ƙarfin jagora, da horo da horo a kowane lokaci) zai zama mafi fa'ida fiye da horo na gargajiya bisa ga bayanin da aka gabatar a cikin harshe bayyananne.Bugu da ƙari kuma, mun kuma yi hasashe cewa horon gait tare da robot A3 a tsaye a tsaye zai kunna tsarin musculoskeletal da cerebrovascular ta hanyar maimaitawa da daidaitaccen shigarwar yanayin tafiya, ta haka yana rage hypertonia spastic da hyperreflexia da inganta farfadowa da wuri daga bugun jini.

Abubuwan da aka gano na yanzu bai tabbatar da cikakken hasashen mu na farko ba.Sakamakon FMA ya nuna cewa ƙungiyoyin biyu sun nuna ci gaba mai mahimmanci.Bugu da ƙari, a farkon lokaci, amfani da na'urar mutum-mutumi don horar da ma'auni na gait ya haifar da kyakkyawan aiki fiye da horon gyaran ƙasa na gargajiya.Bayan horon gait na taimakon robot, marasa lafiya bazai iya aiwatar da daidaitaccen tafiya cikin sauri da fasaha ba, kuma lokacin marasa lafiya da sigogin sararin samaniya sun ɗan fi girma fiye da kafin horo (ko da yake wannan bambancin ba shi da mahimmanci, P> 0: 05), tare da babu wani bambanci mai mahimmanci a cikin ƙimar TUG kafin da bayan horo (P = 0: 28).Duk da haka, ba tare da la'akari da hanyar ba, makonni 2 na ci gaba da horarwa bai canza ma'auni na lokaci ba a cikin tafiyar marasa lafiya ko matakan mataki a cikin sararin samaniya.

Abubuwan da aka gano na yanzu sun yi daidai da wasu rahotannin da suka gabata, suna goyan bayan ra'ayi cewa rawar da kayan aikin lantarki/robot ba su da tabbas [10].Wasu bincike na baya-bayan nan sun nuna cewa horarwar gait na mutum-mutumi na iya taka rawar farko a cikin gyare-gyaren jijiyoyi, samar da ingantaccen shigar da hankali a matsayin jigo na filastik jijiyoyi da tushen koyan mota, wanda ke da mahimmanci don cimma nasarar fitar da motar da ta dace [21].Marasa lafiya waɗanda suka sami haɗin gwiwar horar da gait da aka taimaka ta lantarki da kuma jiyya ta jiki bayan bugun jini sun fi samun damar yin tafiya mai zaman kanta idan aka kwatanta da waɗanda suka karɓi horon gait na al'ada kawai, musamman a farkon watanni 3 bayan bugun jini [7, 14].Bugu da ƙari, wasu nazarin sun nuna cewa dogara ga horar da mutum-mutumi na iya inganta tafiya na marasa lafiya bayan bugun jini.A cikin binciken da Kim et al., An raba marasa lafiya 48 a cikin shekara 1 na rashin lafiya zuwa rukunin jiyya na taimakon robot (0: 5 sa'o'i na horo na robot + awa 1 na jiyya na jiki) da ƙungiyar kulawa ta al'ada (1.5 hours na jiki). far), tare da ƙungiyoyin biyu suna karɓar sa'o'i 1.5 na jiyya kowace rana.Idan aka kwatanta da maganin gargajiya na jiki kaɗai, sakamakon ya nuna cewa haɗa na'urorin mutum-mutumi tare da jiyya ta jiki ya fi na al'ada ta fuskar cin gashin kai da daidaito [22].

Duk da haka, Mayr da abokan aiki sun gudanar da nazarin 66 manya marasa lafiya tare da matsakaita na 5 makonni bayan bugun jini don kimanta tasirin ƙungiyoyi biyu da ke karɓar makonni 8 na maganin gyaran gyare-gyare na marasa lafiya da ke mayar da hankali kan iyawar gait da gyaran gait (horar da robot-taimakawa gait horo da kuma gargajiya ƙasa). horon gait).An ba da rahoton cewa, kodayake ya ɗauki lokaci da kuzari don cimma sakamako masu amfani na motsa jiki na motsa jiki, duka hanyoyin sun inganta aikin gait [15].Hakanan, Duncan et al.yayi nazarin tasirin horon motsa jiki na farko (watanni 2 bayan bugun jini), horo na horo na ƙarshe (watanni 6 bayan bugun jini), da kuma tsarin motsa jiki na gida (watanni 2 bayan bugun jini) don yin nazarin nauyin tallafi na gudu bayan bugun jini, ciki har da mafi kyau duka. lokaci da tasiri na aikin gyaran injiniyoyi.An gano cewa, a cikin 408 manya marasa lafiya da bugun jini (watanni 2 bayan bugun jini), horar da motsa jiki, ciki har da yin amfani da horon motsa jiki don tallafawa nauyi, bai fi dacewa da aikin motsa jiki wanda likitan motsa jiki ya yi a gida [8].Hidler da abokan aiki sun ba da shawarar nazarin RCT da yawa wanda ya haɗa da 72 manya marasa lafiya a kasa da watanni 6 bayan farawar bugun jini.Marubutan sun ba da rahoton cewa a cikin mutanen da ke da matsakaita zuwa matsananciyar matsalar gait bayan bugun jini a cikin ƙasa, yin amfani da dabarun gyara na gargajiya na iya samun saurin gudu da nisa a ƙasa fiye da horon gait ɗin robot (ta amfani da na'urorin Lokomat) [9].A cikin bincikenmu, ana iya gani daga kwatancen da ke tsakanin ƙungiyoyi waɗanda, ban da babban bambancin ƙididdiga a kusurwar ƙafar ƙafar ƙafa, a gaskiya ma, tasirin jiyya na ƙungiyar PT yana kama da na ƙungiyar RT a yawancin bangarori.Musamman dangane da faɗin gait, bayan makonni 2 na horo na PT, kwatancen intragroup yana da mahimmanci (P = 0:02).Wannan yana tunatar da mu cewa a cikin cibiyoyin horarwa ba tare da yanayin horo na mutum-mutumi ba, horar da tafiya tare da horar da gait na kasa da kasa na iya cimma wani tasiri na warkewa.

Dangane da abubuwan da suka shafi asibiti, binciken da aka yi a halin yanzu yana nuna cewa, don horar da motsa jiki na asibiti don bugun jini na farko, lokacin da faɗin majinyacin yana da matsala, ya kamata a zaɓi horon gait na yau da kullun;akasin haka, lokacin da ma'aunin sararin samaniya na majiyyaci (tsawon mataki, taki, da kusurwar yatsan ƙafa) ko sigogin lokaci (tsawon ma'auni na ma'auni) ya bayyana matsalar gait, zabar horarwar gait na taimakon robot na iya zama mafi dacewa.Koyaya, babban ƙayyadaddun gwajin da aka bazu na yanzu shine ɗan gajeren lokacin horo (makonni 2), yana iyakance abubuwan da za'a iya ɗauka daga bincikenmu.Zai yiwu bambance-bambancen horo tsakanin hanyoyin biyu zai bayyana bayan makonni 4.Ƙuntatawa na biyu yana da alaƙa da yawan binciken.An gudanar da binciken na yanzu tare da marasa lafiya tare da bugun jini na ƙananan matakan daban-daban na tsanani, kuma ba mu iya bambanta tsakanin farfadowa ba tare da bata lokaci ba (ma'anar farfadowa na jiki ba tare da bata lokaci ba) da kuma farfadowa na warkewa.Lokacin zaɓin (makonni 8) daga farkon bugun jini ya daɗe sosai, mai yuwuwa ya haɗa da adadin wuce gona da iri na mabambantan juyi na juyin halitta da juriya na mutum ga damuwa (horo).Wani ƙayyadaddun ƙayyadaddun ƙayyadaddun ƙayyadaddun ƙayyadaddun ƙayyadaddun ƙayyadaddun ƙayyadaddun ƙayyadaddun ƙayyadaddun ƙayyadaddun ƙayyadaddun ma'auni na dogon lokaci (misali, watanni 6 ko sama da haka kuma mafi kyawun shekara 1).Bugu da ƙari, fara jiyya (watau RT) da wuri na iya ba zai haifar da bambance-bambancen da za a iya aunawa ba a cikin sakamakon gajeren lokaci, ko da ya sami bambanci a sakamakon dogon lokaci.

5. Kammalawa

Wannan binciken na farko ya nuna cewa duka A3 robot-taimakawa horarwar gait da horon gait na ƙasa na al'ada na iya haɓaka ƙarfin tafiya na marasa lafiyar bugun jini a cikin makonni 2.

Samun Bayanai

Rubutun bayanan da aka yi amfani da su a cikin wannan binciken suna samuwa daga mawallafin da ya dace bisa ga buƙatu mai ma'ana.

Rigingimun Maslaha

Mawallafa sun bayyana cewa babu wani rikici na sha'awa.

Godiya

Mun gode wa Benjamin Knight, MSc., daga Liwen Bianji, Editing China (http://www.liwenbianji.cn/ac), don gyara rubutun Turanci na daftarin wannan rubutun.

Magana

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Lokacin aikawa: Nuwamba-15-2021
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