Lefeber Nina, Swinnen Eva, Kerckhofs Eric
a Faculty of Physical Education and Physiotherapy , Rehabilitation Research, Vrije Universiteit Brussel , Brussels , Belgium.
b C4N, Center for Neurosciences, Vrije Universiteit Brussel , Brussels , Belgium.
Disabil Rehabil Assist Technol. 2017 Oct;12(7):657-671. doi: 10.1080/17483107.2016.1235620. Epub 2016 Oct 20.
The integration of sufficient cardiovascular stress into robot-assisted gait (RAG) training could combine the benefits of both RAG and aerobic training. The aim was to summarize literature data on the immediate effects of RAG compared to walking without robot-assistance on metabolic-, cardiorespiratory- and fatigue-related parameters.
PubMed and Web of Science were searched for eligible articles till February 2016. Means, SDs and significance values were extracted. Effect sizes were calculated.
Fourteen studies were included, concerning 155 participants (85 healthy subjects, 39 stroke and 31 spinal cord injury patients), 9 robots (2 end-effectors, 1 treadmill-based and 6 wearable exoskeletons), and 7 outcome parameters (mostly oxygen consumption and heart rate). Overall, metabolic and cardiorespiratory parameters were lower during RAG compared to walking without robot-assistance (moderate to large effect sizes). In healthy subjects, when no body-weight support (BWS) was provided, RAG with an end-effector device was more energy demanding than walking overground (p > .05, large effect sizes).
Generally, results suggest that RAG is less energy-consuming and cardiorespiratory stressful than walking without robot-assistance, but results depend on factors such as robot type, walking speed, BWS and effort. Additional research is needed to draw firm conclusions. Implications for Rehabilitation Awareness of the energy consumption and cardiorespiratory load of robot-assisted gait (RAG) training is important in the rehabilitation of (neurological) patients with impaired cardiorespiratory fitness and patients who are at risk of cardiovascular diseases. On the other hand, the integration of sufficient cardiometabolic stress in RAG training could combine the effects of both RAG and aerobic training. Energy consumption and cardiorespiratory load during walking with robot-assistance seems to depend on factors such as robot type, walking speed, body-weight support or amount of effort. These parameters could be adjusted in RAG rehabilitation to make RAG more or less energy-consuming and cardiorespiratory stressful. Overall, short duration exoskeleton walking seems less energy-consuming and cardiorespiratory stressful than walking without robot-assistance. This might implicate that the exercise intensity is safe for (neurological) patients at risk of cardiovascular diseases. How this changes in extended walking time is unclear.
将足够的心血管应激融入机器人辅助步态（RAG）训练中，可以结合RAG和有氧训练的益处。目的是总结与无机器人辅助行走相比，RAG对代谢、心肺和疲劳相关参数的即时影响的文献数据。
检索PubMed和Web of Science截至2016年2月的符合条件的文章。提取均值、标准差和显著性值。计算效应量。
纳入14项研究，涉及155名参与者（85名健康受试者、39名中风患者和31名脊髓损伤患者）、9台机器人（2个末端执行器、1个基于跑步机的和6个可穿戴外骨骼）以及7个结果参数（主要是耗氧量和心率）。总体而言，与无机器人辅助行走相比，RAG期间的代谢和心肺参数较低（效应量为中度至大）。在健康受试者中，当不提供体重支持（BWS）时，使用末端执行器装置的RAG比地面行走需要更多能量（p＞0.05，效应量为大）。
一般来说，结果表明RAG比无机器人辅助行走消耗的能量更少，对心肺的压力更小，但结果取决于机器人类型、行走速度、BWS和努力程度等因素。需要更多研究才能得出确凿结论。对康复的启示了解机器人辅助步态（RAG）训练的能量消耗和心肺负荷，对于心肺功能受损的（神经）患者以及有心血管疾病风险的患者的康复很重要。另一方面，在RAG训练中融入足够的心脏代谢应激可以结合RAG和有氧训练的效果。机器人辅助行走期间的能量消耗和心肺负荷似乎取决于机器人类型、行走速度、体重支持或努力程度等因素。这些参数可以在RAG康复中进行调整，以使RAG或多或少消耗能量并对心肺造成压力。总体而言，短时间的外骨骼行走似乎比无机器人辅助行走消耗的能量更少，对心肺的压力更小。这可能意味着运动强度对有心血管疾病风险的（神经）患者是安全的。长时间行走时这种情况如何变化尚不清楚。
