Rupp Rüdiger, Plewa Harry, Schuld Christian, Gerner Hans Jürgen, Hofer Eberhard P, Knestel Markus
Heidelberg University Hospital, Spinal Cord Injury Center, Germany.
Biomed Tech (Berl). 2011 Feb;56(1):11-21. doi: 10.1515/BMT.2010.051. Epub 2010 Nov 17.
In incomplete spinal cord injured subjects, task-oriented training regimes are applied for enhancement of neuroplasticity to improve gait capacity. However, a sufficient training intensity can only be achieved during the inpatient phase, which is getting shorter and shorter due to economic restrictions. In the clinical environment, complex and expensive robotic devices have been introduced to maintain the duration and the intensity of the training, but up to now only a few exist for continuation of automated locomotion training at home. For continuation of the automated locomotion training at home prototypes of the compact, pneumatically driven orthosis MoreGait have been realized, which generate the key afferent stimuli for activation of the spinal gait pattern generator. Artificial pneumatic muscles with excellent weight-to-force ratio and safety characteristics have been integrated as joint actuators. Additionally, a Stimulative Shoe for generation of the appropriate foot loading pattern has been developed without the need for verticalization of the user. The first results of the pilot study in eight chronic incomplete spinal cord injured subjects indicate that the home-based therapy is safe and feasible. The therapy related improvements of the walking capacity are in the range of locomotion robots used in clinical settings.
在不完全性脊髓损伤患者中，采用以任务为导向的训练方案来增强神经可塑性，以提高步态能力。然而，只有在住院期间才能达到足够的训练强度，而由于经济限制，住院时间正变得越来越短。在临床环境中，已引入复杂且昂贵的机器人设备来维持训练的时长和强度，但到目前为止，仅有少数设备可用于在家中继续进行自动运动训练。为了在家中继续进行自动运动训练，已经实现了紧凑型气动矫形器MoreGait的原型，该原型可产生关键的传入刺激，以激活脊髓步态模式发生器。具有出色重量与力量比及安全特性的人工气动肌肉已被用作关节驱动器。此外，还开发了一种无需使用者垂直化即可产生适当足部负荷模式的刺激鞋。对八名慢性不完全性脊髓损伤患者进行的初步研究的首批结果表明，家庭治疗是安全可行的。与治疗相关的步行能力改善程度与临床环境中使用的运动机器人相当。
