Department of Neurological and Movement Sciences, Neuromotor and Cognitive Rehabilitation Research Center, University of Verona Verona, Italy.
Department of Neurological Rehabilitation, Private Hospital Villa Melitta Bolzano, Italy.
Front Hum Neurosci. 2014 May 22;8:318. doi: 10.3389/fnhum.2014.00318. eCollection 2014.
Extensive research on both healthy subjects and patients with central nervous damage has elucidated a crucial role of postural adjustment reactions and central sensory integration processes in generating and "shaping" locomotor function, respectively. Whether robotic-assisted gait devices might improve these functions in Multiple sclerosis (MS) patients is not fully investigated in literature.
The aim of this study was to compare the effectiveness of end-effector robot-assisted gait training (RAGT) and sensory integration balance training (SIBT) in improving walking and balance performance in patients with MS.
Twenty-two patients with MS (EDSS: 1.5-6.5) were randomly assigned to two groups. The RAGT group (n = 12) underwent end-effector system training. The SIBT group (n = 10) underwent specific balance exercises. Each patient received twelve 50-min treatment sessions (2 days/week). A blinded rater evaluated patients before and after treatment as well as 1 month post treatment. Primary outcomes were walking speed and Berg Balance Scale. Secondary outcomes were the Activities-specific Balance Confidence Scale, Sensory Organization Balance Test, Stabilometric Assessment, Fatigue Severity Scale, cadence, step length, single and double support time, Multiple Sclerosis Quality of Life-54.
Between groups comparisons showed no significant differences on primary and secondary outcome measures over time. Within group comparisons showed significant improvements in both groups on the Berg Balance Scale (P = 0.001). Changes approaching significance were found on gait speed (P = 0.07) only in the RAGT group. Significant changes in balance task-related domains during standing and walking conditions were found in the SIBT group.
Balance disorders in patients with MS may be ameliorated by RAGT and by SIBT.
广泛的研究表明，健康受试者和中枢神经系统损伤患者的姿势调整反应和中枢感觉整合过程在产生和“塑造”运动功能方面分别起着至关重要的作用。然而，机器人辅助步态训练（RAGT）是否可以改善多发性硬化症（MS）患者的这些功能，文献中尚未完全探讨。
本研究旨在比较末端效应器机器人辅助步态训练（RAGT）和感觉整合平衡训练（SIBT）对改善 MS 患者步行和平衡功能的效果。
22 名 MS 患者（EDSS：1.5-6.5）被随机分为两组。RAGT 组（n = 12）接受末端效应器系统训练。SIBT 组（n = 10）接受特定的平衡练习。每位患者接受 12 次 50 分钟的治疗（每周 2 天）。一位盲评者在治疗前后以及治疗后 1 个月对患者进行评估。主要结局是步行速度和 Berg 平衡量表。次要结局是活动特异性平衡信心量表、感觉组织平衡测试、稳定评估、疲劳严重程度量表、步速、步长、单支撑和双支撑时间、多发性硬化症生活质量-54。
组间比较显示，在治疗期间，主要和次要结局指标均无显著差异。组内比较显示，两组 Berg 平衡量表均有显著改善（P = 0.001）。仅在 RAGT 组，步行速度有显著改善（P = 0.07）。在 SIBT 组，站立和行走条件下的平衡任务相关领域的变化接近显著。
RAGT 和 SIBT 均可改善 MS 患者的平衡障碍。
