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一种新型射频控制神经假体对慢性偏瘫患者步态对称性和节律性的影响。

Effects of a new radio frequency-controlled neuroprosthesis on gait symmetry and rhythmicity in patients with chronic hemiparesis.

作者信息

Hausdorff Jeffrey M, Ring Haim

机构信息

Department of Physical Therapy, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.

出版信息

Am J Phys Med Rehabil. 2008 Jan;87(1):4-13. doi: 10.1097/PHM.0b013e31815e6680.

Abstract

OBJECTIVE

To assess the effects of a new neuroprosthesis (NESS L300) designed to ameliorate foot drop on gait symmetry and rhythmicity during walking.

DESIGN

Twenty-four patients (mean age: 54.0 +/- 13.5 yrs) with chronic hemiparesis (5.8 +/- 5.2 yrs) whose walking was impaired by foot drop. Subjects walked for 6 mins while wearing force-sensitive insoles, once with and once without the neuroprosthesis, in randomized order. Additional assessments with the neuroprosthesis were conducted after using the device for 4 and 8 wks. Walking speed, swing, and stride time were determined, along with a gait asymmetry index and stride time variability-both markers of gait stability and fall risk.

RESULTS

While wearing the neuroprosthesis, the gait asymmetry index instantly improved by 28% (from 0.58 +/- 0.30 to 0.42 +/- 0.22) and by 45% (to 0.32 +/- 0.20; P < 0.001) after 8 wks. Stride time variability decreased by 23% immediately (from 5.7 +/- 2.9% to 4.4 +/- 1.3%) and by 33% (to 3.8 +/- 1.4%; P = 0.002) after 8 wks. Walking speed improved initially by 17% (from 0.53 +/- 0.24 to 0.62 +/- 0.22 m/sec) and after 8 wks by 34% (to 0.71 +/- 0.25 m/sec; P < 0.001).

CONCLUSIONS

The studied neuroprosthesis enhances gait and improves dynamic stability in chronic hemiparetic patients, supporting the idea that this is a viable treatment option in the rehabilitation of patients with foot drop.

摘要

目的

评估一种旨在改善足下垂的新型神经假体(NESS L300)对行走过程中步态对称性和节律性的影响。

设计

24例慢性偏瘫患者(平均年龄:54.0±13.5岁,病程5.8±5.2年),其行走因足下垂而受损。受试者穿着力敏鞋垫行走6分钟,一次佩戴神经假体,一次不佩戴,顺序随机。在使用该装置4周和8周后,进行了额外的神经假体评估。测定了行走速度、摆动时间和步幅时间,以及步态不对称指数和步幅时间变异性——这两个指标都是步态稳定性和跌倒风险的标志物。

结果

佩戴神经假体时,步态不对称指数立即改善了28%(从0.58±0.30降至0.4±0.22),8周后改善了45%(降至0.32±0.20;P<0.001)。步幅时间变异性立即降低了23%(从5.7±2.9%降至4.4±1.3%),8周后降低了33%(降至3.8±1.4%;P=0.002)。行走速度最初提高了17%(从0.53±0.24米/秒提高到0.62±0.22米/秒),8周后提高了34%(提高到0.71±0.25米/秒;P<0.001)。

结论

所研究的神经假体可增强慢性偏瘫患者的步态并改善动态稳定性,支持了这是足下垂患者康复的一种可行治疗选择的观点。

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