Stein Joel, Bishop Lauri, Stein Daniel J, Wong Christopher Kevin
From the Department of Rehabilitation and Regenerative Medicine, Columbia University College of Physicians and Surgeons (JS, LB, CKW); Division of Rehabilitation Medicine, Weill Cornell Medical College (JS); Department of Rehabilitation Medicine, New York-Presbyterian Hospital, New York, New York (JS); and Department of Medicine, University of Virginia Medical Center, Charlottesville, Virginia (DJS).
Am J Phys Med Rehabil. 2014 Nov;93(11):987-94. doi: 10.1097/PHM.0000000000000119.
Robot-aided exercise therapy is a promising approach to enhance walking ability in stroke survivors. This study was designed to test a new robotic knee brace for restoring mobility in stroke survivors.
Twenty-four ambulatory individuals with chronic hemiparesis after stroke were enrolled in this pilot study. The participants were randomly assigned in equal numbers to either treatment with the experimental device or to a group exercise program and received a total of 18 hrs of their assigned therapy during a 6-wk training period. The primary outcome was gait velocity, as measured with the 10-m walk test. Secondary measures included 6-min walk test, Timed Up and Go test, Five-Times-Sit-to-Stand test, Romberg test, Emory Functional Ambulation Profile, Berg Balance scale, and the California Functional Evaluation 40.
Twenty subjects completed the entire protocol and all follow-up visits. No significant differences between the two groups were found for the primary outcome measure at either the completion of training (week 6) or at the 3-mo follow-up (week 19), with inconsistent findings for secondary measures. No within-group changes were seen in the primary outcome measure (10-m walk test) in either group. Within-group improvements were seen in several of the secondary measures for both groups. No complications of robotic therapy were observed.
Robotic therapy for ambulatory stroke patients with chronic hemiparesis using a robotic knee brace resulted in only modest functional benefits that were comparable with a group exercise intervention.
机器人辅助运动疗法是一种有望提高中风幸存者步行能力的方法。本研究旨在测试一种新型机器人膝关节支具，以恢复中风幸存者的活动能力。
本试点研究纳入了24名中风后慢性偏瘫的可步行个体。参与者被随机等分为两组，一组使用实验装置进行治疗，另一组进行团体运动项目，在为期6周的训练期间，每组共接受18小时的指定治疗。主要结局指标是通过10米步行测试测量的步态速度。次要测量指标包括6分钟步行测试、计时起立行走测试、五次坐立测试、罗姆伯格测试、埃默里功能步行量表、伯格平衡量表和加利福尼亚功能评估40。
20名受试者完成了整个方案及所有随访。在训练结束时（第6周）或3个月随访时（第19周），两组在主要结局指标上均未发现显著差异，次要测量指标的结果不一致。两组的主要结局指标（10米步行测试）均未出现组内变化。两组的几个次要测量指标均出现了组内改善。未观察到机器人治疗的并发症。
使用机器人膝关节支具对患有慢性偏瘫的可步行中风患者进行机器人治疗，仅产生了适度的功能益处，与团体运动干预相当。
