Uçar Demet Erdoğan, Paker Nurdan, Buğdaycı Derya
Department of Physical Medicine and Rehabilitation, Dicle University Medical Faculty, Diyarbakir, Turkey.
Department of Physical Medicine and Rehabilitation, Istanbul Physical Medicine and Rehabilitation Training Hospital, Istanbul, Turkey.
NeuroRehabilitation. 2014;34(3):447-53. doi: 10.3233/NRE-141054.
Treadmill training with partial body weight support has been suggested as a useful strategy for gait rehabilitation after stroke.
This prospective, randomized, controlled study of gait training tested the feasibility and potential efficacy of using a robotic-assisted gait device, Lokomat, for treadmill training with partial body weight support in subjects with chronic hemiplegia; the device was also compared with conventional home exercise.
Twenty-two male ambulatory ischemic or hemorrhagic induced stroke patients with chronic hemiplegia lasting at least 12 months were enrolled in this prospective study. The patients were assigned to either the Lokomat group or the conventional exercise group. The Lokomat group underwent active robotic training for ten sessions (five sessions per week for two weeks). Each session lasted 30 minutes. If a patient missed three consecutive training sessions, he was removed from the study. The Timed Up and Go Test is used to assess mobility and requires both static and dynamic balance. The 10-m Timed Walking Speed Test is designed to determine the patient's overground walking speed. The Mini-Mental State Examination and Hospital Anxiety and Depression Scale were used for mental and psychological evaluation; the Functional Ambulation Categories was used to assess ambulatory status.
Within each eight-week interval, the patients undergoing the Lokomat training demonstrated significantly greater improvement on the Timed Up and Go Test and 10-m Timed Walking Speed Test than those undergoing conventional training.
Despite the small number of patients in the study, the present data suggests that the robotic-assisted device, Lokomat, provides innovative possibilities for gait training in chronic hemiplegia rehabilitation by training at higher intensity levels for longer durations than traditional home exercise.
部分体重支持的跑步机训练已被认为是中风后步态康复的一种有效策略。
这项关于步态训练的前瞻性、随机、对照研究测试了使用机器人辅助步态设备Lokomat进行部分体重支持的跑步机训练对慢性偏瘫患者的可行性和潜在疗效；还将该设备与传统家庭锻炼进行了比较。
22名因缺血性或出血性中风导致慢性偏瘫且持续至少12个月的男性可步行患者参与了这项前瞻性研究。患者被分配到Lokomat组或传统锻炼组。Lokomat组接受了为期十节的主动机器人训练（每周五节，共两周）。每节训练持续30分钟。如果患者连续错过三节训练课，将被排除出研究。计时起立行走测试用于评估移动能力，需要静态和动态平衡。10米计时步行速度测试旨在确定患者的地面行走速度。简易精神状态检查表和医院焦虑抑郁量表用于精神和心理评估；功能性步行分类用于评估步行状态。
在每八周的时间间隔内，接受Lokomat训练的患者在计时起立行走测试和10米计时步行速度测试中的改善明显大于接受传统训练的患者。
尽管本研究中的患者数量较少，但目前的数据表明，机器人辅助设备Lokomat通过比传统家庭锻炼更高强度、更长时间的训练，为慢性偏瘫康复中的步态训练提供了创新的可能性。
