数智化技术在神经肌肉系统罕见病康复中的研究现状

Current Research Status of Digital Technology in the Rehabilitation of Rare Neurological and Muscular Diseases

  • 摘要:
    目的 系统梳理国内外评价神经肌肉系统疾病数智化康复措施的随机对照研究,总结数智化康复治疗的现状与效果,提炼神经肌肉系统罕见病患者的特殊康复需求,以及面临的困难与挑战,为神经肌肉系统罕见病康复治疗工作的开展和质量提升提供证据支撑。
    方法 在PubMed、Web of Science、Embase、中国知网、维普中文科技期刊数据库、万方数据知识服务平台中,系统检索自建库起至2024年6月发表的所有与神经肌肉系统疾病、罕见病、数智化技术、康复治疗等相关的文献,提取文献基本信息和研究相关信息进行汇总分析。
    结果 共纳入43篇随机对照试验文献,均为英文,分别来自14个国家,研究疾病主要为帕金森病和多发性硬化。数智化康复技术在神经肌肉系统疾病康复中的应用仍处于起步阶段,目前常用技术包括虚拟现实游戏、智能辅助跑步机、辅助步态训练机器人、可穿戴式半机械人混合辅助肢体、远程康复系统和可穿戴传感器。应用场景为患者家庭或康复服务中心。虚拟现实游戏对动、静态平衡功能和认知功能的康复有显著改善;智能辅助跑步机对步态速度和步幅有显著提升;辅助步态训练机器人对平衡功能、步态速度和步幅有显著改善;可穿戴式半机械人混合辅助肢体对行走能力有显著提升。
    结论 “数智化技术”驱动的康复治疗已在神经肌肉系统疾病的康复领域展现出巨大的价值和潜力,其表现出的优势和特点与罕见病康复面临的多种需求具有高度契合性。未来应围绕神经肌肉系统罕见病康复的迫切需求,积极探索构建分级协作的康复治疗服务体系,充分结合“数”与“智”各自的优势,使罕见病患者可就近获得标准统一、科学规范、方便可及、经济可负担的康复服务。

     

    Abstract:
    Objective To review the randomized controlled trials (RCTs) at home and abroad on digital intelligence (DI)-driven rehabilitation in patients of neuromuscular disease, compare the effects of DI-driven rehabilitation with traditional rehabilitation, summarize the special needs and challenges faced by patients in rehabilitation of rare neuromuscular diseases, and provide evidence for the development and quality improvement of rehabilitation for rare neuromuscular diseases.
    Methods We searched PubMed, Web of Science, Embase, CNKI, VIP, and Wanfang databases for literature on neuromuscular diseases, rare diseases, digital and intelligent technologies, and rehabilitation published from the inception of the databases to June 2024. Basic and research-related information from the retrieved literature was extracted and analyzed.
    Results A total of 43 RCTs in English from 14 countries were included. The most studied diseases were Parkinson′s disease and multiple sclerosis. The application of DI-driven technologies in rehabilitation of rare neuromuscular diseases was still limited. The commonly used technologies were virtual reality (VR) games, intelligent treadmill assistance, gait training robots, hybrid assistive limb (HAL), wearable sensors and tele-rehabilitation (TR) systems. These technologies were applied in patients′ homes or rehabilitation service centers. The VR games significantly improved both static/dynamic balance functions and cognitive functions. The intelligent treadmill assistance significantly enhanced gait speed and stride length. The gait training robots significantly improved balance, gait speed and stride length of patients. The wearable exoskeletons significantly enhanced walking ability.
    Conclusions DI-driven rehabilitation measures have great value and potential in the field of neuromuscular disease rehabilitation. Their advantages and characteristics can meet the diverse needs of rare disease patients. In the future, a hierarchical and collaborative rehabilitation service system should be established to meet the urgent needs of the rehabilitation of rare neuromuscular diseases. Combining the advantages of digitization and intelligence will provide standardized, scientific, convenient and affordable rehabilitation services to patients.

     

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