Niu X, Patel C, Varoqui D, Mirbagheri M M
Dept of Physical Medicine and Rehabilitation, Northwestern University.
Annu Int Conf IEEE Eng Med Biol Soc. 2011;2011:3542-5. doi: 10.1109/IEMBS.2011.6090589.
To explore the effect of LOKOMAT and LOKOMAT+Tizanidine on the improvement of walking capacity for people with spinal cord injury (SCI), 20 SCI subjects with hypertonia spasticity at their ankle joints participated in a 12-session Lokomat training; among them, 10 subjects received Tizanidine. 1-hour LOKOMAT training was provided 3 times per week for 4-weeks. Subjects were evaluated 4 times for Timed-Up-and-Go, 10-Meter-Walking, and 6-Minute-Walking testings, at the baseline, 1-, 2- and 4-weeks after training. Latent Class Growth model was used to classify the LOKOMAT training speed, and clinical walking evaluations. Subjects in each treatment group could be classified into two subclasses for training speed and clinical evaluation. It was found that the training speed increased in all treatment group, while the subjects in LOKOMAT+Tizanidine presented a significant improvement of their training speed from the training session. The clinical evaluations classified subjects similarly, and no significant improvement of clinical measurements was observed for either treatment. The MVC dorsiflexion torque at the ankle joint was able to predict the class memberships of subjects for their walking capacity and can be used as a significant predictor for therapeutic functional recovery after spinal cord injury.
为探讨下肢康复训练机器人(LOKOMAT)及LOKOMAT联合替扎尼定对脊髓损伤(SCI)患者步行能力改善的影响,20名踝关节存在张力亢进性痉挛的SCI患者参与了为期12节的LOKOMAT训练;其中,10名患者接受了替扎尼定治疗。每周进行3次,每次1小时的LOKOMAT训练,共持续4周。在训练前基线、训练后1周、2周和4周对患者进行4次定时起立行走测试、10米步行测试和6分钟步行测试评估。采用潜在类别增长模型对LOKOMAT训练速度及临床步行评估进行分类。每个治疗组的患者在训练速度和临床评估方面均可分为两个亚组。结果发现,所有治疗组的训练速度均有所提高,而LOKOMAT联合替扎尼定组的患者从训练开始其训练速度就有显著提高。临床评估对患者的分类相似,两种治疗方法的临床测量均未观察到显著改善。踝关节背屈最大随意收缩扭矩能够预测患者步行能力的类别归属,可作为脊髓损伤后治疗性功能恢复的重要预测指标。