帕金森病的机器人辅助步态训练:一项为期三个月的随访随机临床试验。
Robotic-assisted gait training in Parkinson's disease: a three-month follow-up randomized clinical trial.
作者信息
Furnari Anna, Calabrò Rocco Salvatore, De Cola Maria Cristina, Bartolo Michelangelo, Castelli Alberto, Mapelli Alessia, Buttacchio Giampiero, Farini Elena, Bramanti Placido, Casale Roberto
机构信息
a Neurorehabilitation Unit , HABILITA Care & Research Rehabilitation Hospitals , Zingonia di Ciserano (Bergamo) , Zingonia , Italy.
b IRCCS Centro Neurolesi "Bonino-Pulejo" , Messina , Italy.
出版信息
Int J Neurosci. 2017 Nov;127(11):996-1004. doi: 10.1080/00207454.2017.1288623. Epub 2017 Feb 13.
PURPOSE
The aim of this study was to evaluate the efficacy of a robotic-assisted gait training (RAGT), together with a conventional exercise program (CEP), to improve PD ambulation, as compared to standard gait training.
METHODS
Thirty-eight patients with mild PD stage (H&Y 2-2.5) were randomly assigned to an experimental group (EG) or a control group. The 19 patients in EG received 30 min RAGT (using Lokomat device), whereas the 19 controls received a conventional gait training; both groups received 30 min of CEP. Participants were evaluated before (T0), immediately after (T1), and 12 weeks after the end of treatment (T2), by using 10-MWT, Tinetti Test and the motor score of the UPDRS-III.
RESULTS
We found that Tinetti Walking (TW) (X(3) = 31.75; p < 0.001), Tinetti Balance (X(3) = 74.07; p < 0.001), UPDRS-III (X(3) = 6.87; p < 0.001) and GDS (X(3) = 28.83; p < 0.001) scores were affected by the type of the rehabilitative treatment. At T2, we found a significant difference between the two groups for TW (t = 2.62; p < 0.02, d = 0.85). Concerning all the study outcomes, a significant improvement was observed from T0 to T1 in both groups. However, the functional motor gain at T2 was maintained only in the EG.
CONCLUSIONS
RAGT may significantly improve walking ability, motor function and for a maximum period of three months. Thus, our findings support the importance of a RAGT as a valid rehabilitative tool for PD.
目的
本研究旨在评估与标准步态训练相比,机器人辅助步态训练(RAGT)联合传统运动计划(CEP)改善帕金森病(PD)患者步行能力的疗效。
方法
38例轻度PD分期(H&Y 2-2.5)患者被随机分为实验组(EG)或对照组。EG组的19例患者接受30分钟的RAGT(使用Lokomat设备),而19例对照组患者接受传统步态训练;两组均接受30分钟的CEP。在治疗前(T0)、治疗结束后立即(T1)以及治疗结束12周后(T2),使用10米步行试验(10-MWT)、Tinetti测试和帕金森病统一评分量表第三部分(UPDRS-III)的运动评分对参与者进行评估。
结果
我们发现,Tinetti步行(TW)(X(3)=31.75;p<0.001)、Tinetti平衡(X(3)=74.07;p<0.001)、UPDRS-III(X(3)=6.87;p<0.001)和步态障碍评分(GDS)(X(3)=28.83;p<0.001)得分受康复治疗类型的影响。在T2时,我们发现两组在TW方面存在显著差异(t=2.62;p<0.02,d=0.85)。关于所有研究结果,两组从T0到T1均观察到显著改善。然而,仅EG组在T2时保持了功能运动增益。
结论
RAGT可能显著改善步行能力、运动功能,且最长可持续三个月。因此,我们的研究结果支持RAGT作为PD有效康复工具的重要性。