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帕金森病患者的机器人辅助步行训练:一项初步随机对照试验。

Robot-assisted walking training for individuals with Parkinson's disease: a pilot randomized controlled trial.

作者信息

Sale Patrizio, De Pandis Maria Francesca, Le Pera Domenica, Sova Ivan, Cimolin Veronica, Ancillao Andrea, Albertini Giorgio, Galli Manuela, Stocchi Fabrizio, Franceschini Marco

出版信息

BMC Neurol. 2013 May 24;13:50. doi: 10.1186/1471-2377-13-50.

Abstract

BACKGROUND

Over the last years, the introduction of robotic technologies into Parkinson's disease rehabilitation settings has progressed from concept to reality. However, the benefit of robotic training remains elusive. This pilot randomized controlled observer trial is aimed at investigating the feasibility, the effectiveness and the efficacy of new end-effector robot training in people with mild Parkinson's disease.

METHODS

Design. Pilot randomized controlled trial.

RESULTS

Robot training was feasible, acceptable, safe, and the participants completed 100% of the prescribed training sessions. A statistically significant improvement in gait index was found in favour of the EG (T0 versus T1). In particular, the statistical analysis of primary outcome (gait speed) using the Friedman test showed statistically significant improvements for the EG (p = 0,0195). The statistical analysis performed by Friedman test of Step length left (p = 0,0195) and right (p = 0,0195) and Stride length left (p = 0,0078) and right (p = 0,0195) showed a significant statistical gain. No statistically significant improvements on the CG were found.

CONCLUSIONS

Robot training is a feasible and safe form of rehabilitative exercise for cognitively intact people with mild PD. This original approach can contribute to increase a short time lower limb motor recovery in idiopathic PD patients. The focus on the gait recovery is a further characteristic that makes this research relevant to clinical practice. On the whole, the simplicity of treatment, the lack of side effects, and the positive results from patients support the recommendation to extend the use of this treatment. Further investigation regarding the long-time effectiveness of robot training is warranted.

TRIAL REGISTRATION

ClinicalTrials.gov NCT01668407.

摘要

背景

在过去几年中,将机器人技术引入帕金森病康复领域已从概念变为现实。然而,机器人训练的益处仍不明确。这项初步随机对照观察性试验旨在研究新型末端执行器机器人训练对轻度帕金森病患者的可行性、有效性和功效。

方法

设计。初步随机对照试验。

结果

机器人训练是可行的、可接受的且安全的,参与者完成了100%的规定训练课程。发现步态指数有统计学上的显著改善,有利于实验组(T0与T1相比)。特别是,使用弗里德曼检验对主要结局(步速)进行的统计分析显示,实验组有统计学上的显著改善(p = 0.0195)。通过弗里德曼检验对左步长(p = 0.0195)、右步长(p = 0.0195)、左步幅(p = 0.0078)和右步幅(p = 0.0195)进行的统计分析显示有显著的统计学增益。在对照组中未发现统计学上的显著改善。

结论

对于认知功能完好的轻度帕金森病患者,机器人训练是一种可行且安全的康复锻炼形式。这种创新方法有助于特发性帕金森病患者在短时间内实现下肢运动功能恢复。专注于步态恢复是使本研究与临床实践相关的另一个特点。总体而言,治疗的简便性、无副作用以及患者的积极结果支持推广使用这种治疗方法的建议。有必要进一步研究机器人训练的长期有效性。

试验注册

ClinicalTrials.gov NCT01668407。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ccb8/3665527/e9581d0bcfe9/1471-2377-13-50-1.jpg

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