目的 验证下肢康复机器人联合血流限制训练在前交叉韧带重建术后早期康复中的协同效应。方法 2024-01至2024-12在联勤保障部队大连康复疗养中心行前交叉韧带重建术后康复治疗的青年男性90例,随机分为机器人组、血流限制组、联合组,每组各30例。术后2周内,三组均接受常规康复训练。术后3~6周,增加不同干预措施：机器人组增加下肢康复机器人训练,血流限制组增加血流限制训练,联合组增加下肢康复机器人联合血流限制训练。对比干预后三组大腿围度差值、伸膝肌群峰力矩、平均步长、平均步频、重心移动轨迹总长、Lysholm评分及康复过程中不良事件发生情况。结果 干预后,三组间大腿围度差值、重心移动轨迹总长明显小于干预前,伸膝肌群峰力矩、平均步长、平均步频、Lysholm评分均明显大于干预前（均P<0.05）。干预后,联合组和血流限制组大腿围度差值明显小于机器人组（P<0.05）,联合组明显小于血流限制组（P<0.05）;联合组和血流限制组伸膝肌群峰力矩明显大于机器人组（P<0.05）,联合组明显大于血流限制组（P<0.05）;联合组和机器人组平均步长、平均步频明显大于血流限制组（P<0.05）,联合组与机器人组无统计学差异（均P>0.05）;联合组和机器人组重心移动轨迹总长明显小于血流限制组（P<0.05）,联合组明显小于机器人组（P<0.05）;联合组Lysholm评分明显大于血流限制组和机器人组（P<0.05）,血流限制组与机器人组无统计学差异（P>0.05）。结论 下肢康复机器人联合血流限制训练在前交叉韧带重建术后患者早期康复中具有协同作用,能显著提升下肢力量和步态功能,改善膝关节整体功能。

Objective To validate the synergistic effect of lower limb rehabilitation robot combined with blood flow restriction training in the early rehabilitation after anterior cruciate ligament reconstruction. Methods A total of 90 young men who underwent rehabilitation after anterior cruciate ligament reconstruction in DaLian Rehabilitation Recuperation Center of PLA Joint Logistics Support Force from January 2024 to December 2024 were randomly divided into a robot group,a blood flow restriction group, and a combined group,with 30 cases in each group. All the three groups received routine rehabilitation training within 2 weeks after surgery. From three to six weeks after surgery,different interventions were added: the robot group received lower limb rehabilitation robot training,the blood flow restriction group received blood flow restriction training,and the combination group received lower limb rehabilitation robot combined with blood flow restriction training. The difference in thigh circumference,peak torque of the knee extensors,average stride length,average stride frequency, total length of the center of gravity movement trajectory,Lysholm score and the incidence of adverse events during rehabilitation were compared between the three groups after the intervention. Results After the intervention,the difference in thigh circumference and the total length of the center of gravity movement trajectory among the three groups were significantly lower than those before the intervention,and the peak torque of the knee extensors,average step length,average step frequency,and Lysholm score were significantly higher than those before the intervention（all P<0.05）. After the intervention,the difference in thigh circumference in the combined group and the blood flow restriction group was significantly smaller than that in the robot group （P<0.05）, and the combined group was significantly smaller than the blood flow restriction group （P<0.05）. The peak torque of the knee extensors in the combined group and the blood flow restriction group was significantly higher than that in the robot group （P<0.05）, and the combined group was significantly higher than the blood flow restriction group（P<0.05）. The average stride length and average stride frequency in the combined group and the robot group were significantly higher than those in the blood flow restriction group （both P<0.05）, and there was no difference between the two groups （both P>0.05）. The total length of the center of gravity movement trajectory in the combined group and the robot group was significantly shorter than that in the blood flow restriction group （P<0.05）, and the combined group was significantly shorter than the robot group （P<0.05）. The Lysholm score of the combined group was significantly higher than that of the flow restriction group and the robot group （P<0.05）, and there was no difference between the flow restriction group and the robot group （P>0.05）. Conclusions The lower limb rehabilitation robot combined with blood flow restriction training has a synergistic effect in the early rehabilitation of patients after anterior cruciate ligament reconstruction,which can significantly improve lower limb strength and gait function, as well as the overall function of knee joint.