Bar-Haim Simona, Harries Netta, Hutzler Yeshayahu, Belokopytov Mark, Dobrov Igor
Human Motion Analysis Laboratory, Assaf-Harofeh Medical Center, Zerifin, Israel.
Disabil Rehabil Assist Technol. 2013 Sep;8(5):417-25. doi: 10.3109/17483107.2012.754954. Epub 2013 Jan 16.
To describe Re-Step™, a novel mechatronic shoe system that measures center of pressure (COP) gait parameters and complexity of COP dispersion while walking, and to demonstrate these measurements in healthy controls and individuals with hemiparesis and cerebral palsy (CP) before and after perturbation training.
The Re-Step™ was used to induce programmed chaotic perturbations to the feet while walking for 30 min for 36 sessions over 12-weeks of training in two subjects with hemiparesis and two with CP.
Baseline measurements of complexity indices (fractal dimension and approximate entropy) tended to be higher in controls than in those with disabilities, while COP variability, mean and variability of step time and COP dispersion were lower. After training the disabled subjects these measurement values tended toward those of the controls, along with a decrease in step time, 10 m walk time, average step time, percentage of double support and increased Berg balance score.
This pilot trial reveals the feasibility and applicability of this unique measurement and perturbation system for evaluating functional disabilities and changes with interventions to improve walking. Implication for Rehabilitation Walking, of individuals with cerebral palsy and hemiparesis following stroke, can be viewed in terms of a rigid motor behavior that prevents adaptation to changing environmental conditions. Re-Step system (a) measures and records linear and non-linear gait parameters during free walking to provide a detailed evaluation of walking disabilities, (b) is an intervention training modality that applies unexpected perturbations during walking. This perturbation intervention may improve gait and motor functions of individuals with hemiparesis and cerebral plasy.
描述Re-Step™，一种新型机电一体化鞋系统，该系统可在行走时测量压力中心（COP）步态参数以及COP离散度的复杂性，并在健康对照者以及偏瘫和脑瘫（CP）患者接受扰动训练前后展示这些测量结果。
在两名偏瘫患者和两名CP患者进行为期12周的训练过程中，使用Re-Step™在行走30分钟的过程中对足部施加程序化的混沌扰动，共进行36次训练。
复杂性指数（分形维数和近似熵）的基线测量值在对照组中往往高于残疾患者，而COP变异性、步长时间的均值和变异性以及COP离散度则较低。对残疾受试者进行训练后，这些测量值趋向于对照组，同时步长时间、10米步行时间、平均步长时间、双支撑百分比降低，Berg平衡评分增加。
这项初步试验揭示了这种独特的测量和扰动系统在评估功能残疾以及干预改善行走所带来变化方面的可行性和适用性。对康复的启示 脑瘫和中风后偏瘫患者的行走，可被视为一种僵化的运动行为，阻碍了对不断变化的环境条件的适应。Re-Step系统（a）在自由行走期间测量并记录线性和非线性步态参数，以详细评估行走障碍，（b）是一种在行走期间施加意外扰动的干预训练方式。这种扰动干预可能会改善偏瘫和脑性瘫痪患者的步态和运动功能。
