智慧养老背景下肌少症患者使用康复机器人的动机与障碍研究

Research on the Motivations and Barriers to the Use of Rehabilitation Robots by Sarcopenia Patients in the Context of Smart Elderly Care

摘要: 目的：随着我国老龄化进程加速，肌少症已成为严重损害老年人功能独立性与健康寿命的严峻公共卫生挑战。在“健康中国”与“智慧养老”国家战略背景下，康复机器人虽被视为解决肌少症难题、实现主动健康的关键技术，但在实际推广中面临老年用户接受度低、持续使用意愿弱的困境。本研究旨在基于智慧养老场景，深入探究肌少症患者使用康复机器人的深层动机与多维障碍，以期为打破应用僵局提供理论依据与实践策略。方法：本研究采用文献资料法与案例分析法，以Web of Science、CNKI等权威数据库为来源，系统梳理了2015~2025年间的相关文献。研究构建了整合技术接受模型(TAM)与整合型技术接受与使用模型(UTAUT)的复合理论框架，并结合陕西省智慧养老供给侧改革的实证案例，从绩效期望、努力期望、社群影响及便利条件等维度，对“人–机–环境”交互中的核心要素进行深入剖析。结果：研究发现，患者的使用动机呈现出显著的层级递进特征：从恢复行走自理能力的生理诉求，上升至契合临床抗阻训练原则的精准康复需求，最终指向实现生活自主权与社会连接的高阶心理诉求。然而，阻碍因素更为显著，其核心症结在于康复机器人领域存在严重的“供需错位”；现有技术多基于脑卒中偏瘫模型研发，侧重单侧代偿，严重偏离肌少症患者“双侧肌力均匀衰退”与“步态波动大”的病理特征。这导致硬件上关节轴线不对齐引发物理损伤风险，软件上因老年人皮肤干燥导致肌电信号(sEMG)采集失真，加剧了“人机对抗”效应与技术焦虑。此外，高昂的设备成本与居家运维体系的“服务真空”，构成了难以逾越的环境壁垒。结论：智慧养老背景下，康复机器人应用困境的根源在于技术供给未能针对“衰老”特征进行适应性进化。要打破这一僵局，未来研发必须完成从“神经损伤康复”向“适老功能增强”的范式转移，重点解决生物力学适配性与多模态传感鲁棒性问题；同时，建议在供给侧构建“产品 + 服务”的双轮驱动模式，加快专业康复人才培养以填补服务缺口，从而精准匹配庞大的肌少症康复需求。

Abstract: Objective: With the accelerated aging process in my country, sarcopenia has become a serious public health challenge that severely impairs the functional independence and healthy lifespan of the elderly. Under the national strategies of “Healthy China” and “Smart Elderly Care”, rehabilitation robots are considered a key technology to address the challenges of sarcopenia and achieve proactive health. However, their actual implementation faces difficulties such as low acceptance and weak willingness to continue using them among elderly users. This study aims to deeply explore the underlying motivations and multidimensional barriers to the use of rehabilitation robots by sarcopenia patients in the context of smart elderly care, in order to provide theoretical basis and practical strategies for overcoming the application impasse. Methods: This study adopted literature review and case analysis methods, using authoritative databases such as Web of Science and CNKI to systematically review relevant literature from 2015 to 2025. The study constructed a composite theoretical framework integrating the Technology Acceptance Model (TAM) and the Unified Theory of Acceptance and Use of Technology (UTAUT), and combined it with empirical cases of supply-side reform in smart elderly care in Shaanxi Province. It deeply analyzed the core elements in “human-machine-environment” interaction from the dimensions of performance expectancy, effort expectancy, social influence, and facilitating conditions. Results: The study found that patients’ motivations for using rehabilitation robots showed a significant hierarchical progression: from the physiological need to restore walking and self-care abilities, to the precise rehabilitation needs that align with clinical resistance training principles, and finally to the higher-level psychological needs of achieving autonomy in life and social connection. However, the hindering factors were more significant, with the core problem being a serious “supply-demand mismatch” in the field of rehabilitation robots; existing technologies are mostly developed based on stroke hemiplegia models, focusing on unilateral compensation, which seriously deviates from the pathological characteristics of sarcopenia patients, such as “uniform bilateral muscle weakness” and “large gait fluctuations”. This leads to risks of physical injury due to misalignment of joint axes in the hardware, and distortion of electromyographic (sEMG) signal acquisition due to dry skin in the elderly, exacerbating the “human-machine conflict” effect and technological anxiety. Furthermore, the high equipment costs and the “service vacuum” in home-based maintenance systems constitute insurmountable environmental barriers. Conclusion: Under the context of smart elderly care, the root cause of the difficulties in applying rehabilitation robots lies in the failure of technological supply to adaptively evolve to the characteristics of “aging.” To break this deadlock, future research and development must complete a paradigm shift from “neurological injury rehabilitation” to “age-appropriate functional enhancement”, focusing on solving biomechanical adaptability and multi-modal sensing robustness issues. Simultaneously, it is recommended to build a dual-driven model of “product + service” on the supply side, accelerating the training of professional rehabilitation personnel to fill the service gap, thereby precisely matching the vast rehabilitation needs of sarcopenia patients.