Laubacher Marco, Perret Claudio, Hunt Kenneth J
Division of Mechanical Engineering, Department of Engineering and Information Technology, Institute for Rehabilitation and Performance Technology, Bern University of Applied Sciences , Burgdorf , Switzerland , and.
Disabil Rehabil Assist Technol. 2015;10(5):433-8. doi: 10.3109/17483107.2014.908246. Epub 2014 Apr 8.
Robotics-assisted tilt-table (RTT) technology allows neurological rehabilitation therapy to be started early thus alleviating some secondary complications of prolonged bed rest. This study assessed the feasibility of a novel work-rate-guided RTT approach for cardiopulmonary training and assessment in patients with incomplete spinal cord injury (iSCI).
Three representative subjects with iSCI at three distinct stages of primary rehabilitation completed an incremental exercise test (IET) and a constant load test (CLT) on a RTT augmented with integrated leg-force and position measurement and visual work rate feedback. Feasibility assessment focused on: (i) implementation, (ii) limited efficacy testing, (iii) acceptability.
(i) All subjects were able follow the work rate target profile by adapting their volitional leg effort. (ii) During the IETs, peak oxygen uptake above rest was 304, 467 and 1378 ml/min and peak heart rate (HR) was 46, 32 and 65 beats/min above rest (subjects A, B and C, respectively). During the CLTs, steady-state oxygen uptake increased by 42%, 38% and 162% and HR by 12%, 20% and 29%. (iii) All exercise tests were tolerated well.
The novel work-rate guided RTT intervention is deemed feasible for cardiopulmonary training and assessment in patients with iSCI: substantial cardiopulmonary responses were observed and the approach was found to be tolerable and implementable. Implications for Rehabilitation Work-rate guided robotics-assisted tilt-table technology is deemed feasible for cardiopulmonary assessment and training in patients with incomplete spinal cord injury. Robotics-assisted tilt-tables might be a good way to start with an active rehabilitation as early as possible after a spinal cord injury. During training with robotics-assisted devices the active participation of the patients is crucial to strain the cardiopulmonary system and hence gain from the training.
机器人辅助倾斜台（RTT）技术可使神经康复治疗尽早开始，从而减轻长期卧床休息的一些继发性并发症。本研究评估了一种新型的工作率引导的RTT方法用于不完全性脊髓损伤（iSCI）患者心肺训练和评估的可行性。
三名处于初级康复三个不同阶段的代表性iSCI患者，在配备了集成腿部力量和位置测量以及视觉工作率反馈功能的RTT上完成了递增运动试验（IET）和恒负荷试验（CLT）。可行性评估集中在：（i）实施情况，（ii）有限疗效测试，（iii）可接受性。
（i）所有受试者都能够通过调整其自主腿部用力来遵循工作率目标曲线。（ii）在IET期间，静息时的峰值摄氧量分别为304、467和1378毫升/分钟，静息时的峰值心率分别比静息时高46、32和65次/分钟（分别为受试者A、B和C）。在CLT期间，稳态摄氧量分别增加了42%、38%和162%，心率分别增加了12%、20%和29%。（iii）所有运动试验的耐受性都很好。
新型工作率引导的RTT干预被认为对于iSCI患者的心肺训练和评估是可行的：观察到了显著的心肺反应，并且该方法被认为是可耐受和可实施的。对康复的意义工作率引导的机器人辅助倾斜台技术被认为对于不完全性脊髓损伤患者的心肺评估和训练是可行的。机器人辅助倾斜台可能是脊髓损伤后尽早开始积极康复的一种好方法。在使用机器人辅助设备进行训练期间，患者的积极参与对于使心肺系统承受压力并因此从训练中获益至关重要。
