Patritti Benjamin, Sicari Monica, Deming Lynn, Romaguera Fernanda, Pelliccio Marlena, Benedetti Maria Grazia, Nimec Donna, Bonato Paolo
Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital, Boston, MA 02114, USA.
Annu Int Conf IEEE Eng Med Biol Soc. 2010;2010:2271-4. doi: 10.1109/IEMBS.2010.5627707.
Recent work has examined the feasibility of robotic-assisted gait training in pediatric patients, including children with cerebral palsy (CP). Herein we present a case series describing clinical outcomes in four children with CP who underwent gait training using a robotic driven gait orthosis (DGO) (Pediatric Lokomat©). Children had a diagnosis of spastic diplegia due to CP. They were paired based on functional abilities and observed gait characteristics. Two children had a GMFCS of III and showed excessive ankle plantarflexion during stance. The other two children had a GMFCS of II and displayed a crouch gait pattern. Each subject participated in a 6-week intervention of robotic-assisted gait training that involved three 30-minute sessions per week. Pre-and post-training evaluations were performed including clinical tests of standing and walking function, walking speed, and walking endurance. Clinical gait analysis was also performed using a motion capture system to assess changes in gait mechanics. All subjects showed an improvement in locomotor function. For lower functioning children, this may be mediated by improved trunk control. The use of augmented feedback was associated with larger. However, these results have to be considered with caution because of the limited sample size of the study.
近期的研究探讨了机器人辅助步态训练在儿科患者中的可行性，其中包括患有脑瘫（CP）的儿童。在此，我们呈现一个病例系列，描述了四名患有CP的儿童使用机器人驱动步态矫形器（DGO）（儿童型Lokomat©）进行步态训练后的临床结果。这些儿童被诊断为因CP导致的痉挛性双侧瘫。他们根据功能能力和观察到的步态特征进行配对。两名儿童的粗大运动功能分级系统（GMFCS）为III级，在站立期表现出过度的踝关节跖屈。另外两名儿童的GMFCS为II级，呈现蹲伏步态模式。每个受试者都参与了为期6周的机器人辅助步态训练干预，每周进行三次，每次30分钟。在训练前后进行了评估，包括站立和行走功能的临床测试、步行速度和步行耐力。还使用运动捕捉系统进行了临床步态分析，以评估步态力学的变化。所有受试者的运动功能均有改善。对于功能较低的儿童，这可能是通过改善躯干控制来实现的。增强反馈的使用与更大的改善相关。然而，由于该研究的样本量有限，这些结果必须谨慎看待。
