Medical Park Berlin Humboldtmühle, Charité University Medicine Berlin, Berlin, Germany.
NeuroRehabilitation. 2013;33(1):77-84. doi: 10.3233/NRE-130930.
A task-specific repetitive approach in gait rehabilitation after CNS lesion is well accepted nowadays. To ease the therapists' and patients' physical effort, the past two decades have seen the introduction of gait machines to intensify the amount of gait practice. Two principles have emerged, an exoskeleton- and an endeffector-based approach. Both systems share the harness and the body weight support. With the end-effector-based devices, the patients' feet are positioned on two foot plates, whose movements simulate stance and swing phase.
This article provides an overview on the end-effector based machine's effectiveness regarding the restoration of gait.
For the electromechanical gait trainer GT I, a meta analysis identified nine controlled trials (RCT) in stroke subjects (n = 568) and were analyzed to detect differences between end-effector-based locomotion + physiotherapy and physiotherapy alone.
Patients practising with the machine effected in a superior gait ability (210 out of 319 patients, 65.8% vs. 96 out of 249 patients, 38.6%, respectively, Z = 2.29, p = 0.020), due to a larger training intensity. Only single RCTs have been reported for other devices and etiologies.
The introduction of end-effector based gait machines has opened a new succesful chapter in gait rehabilitation after CNS lesion.
如今，针对中枢神经系统损伤后的步态康复，采用特定任务的重复方法已得到广泛认可。为了减轻治疗师和患者的体力消耗，过去二十年见证了步态机的引入，以增加步态练习的次数。目前已经出现了两种原理，分别是基于外骨骼和末端执行器的方法。这两种系统都共享吊带和体重支撑。在基于末端执行器的设备中，患者的脚放置在两个脚台上，脚台的运动模拟了站立和摆动阶段。
本文综述了基于末端执行器的机器在恢复步态方面的有效性。
针对机电步态训练器 GT I，荟萃分析确定了 9 项针对中风患者（n = 568）的对照试验（RCT），并对其进行了分析，以检测基于末端执行器的运动+物理疗法与单纯物理疗法之间的差异。
使用该机器进行训练的患者在步态能力方面表现出了更好的效果（210 名患者中有 210 名，65.8%，249 名患者中有 96 名，38.6%，Z = 2.29，p = 0.020），这归因于更大的训练强度。其他设备和病因的报告仅有单一 RCT。
基于末端执行器的步态机的引入开创了中枢神经系统损伤后步态康复的新篇章。
