Wallard L, Dietrich G, Kerlirzin Y, Bredin J
Université catholique de Louvain, Secteur des Sciences de la Santé, Institut de Recherche Expérimentale et Clinique, Neuro Musculo Skeletal Lab (NMSK), Avenue Mounier 53, B-1200 Brussels, Belgium.
Laboratoire Education Discours Apprentissages EA4071, Centre Universitaire des Saints-Pères, 45 rue des Saints-Pères, 75270 Paris Cedex 06, France.
Eur J Paediatr Neurol. 2017 May;21(3):557-564. doi: 10.1016/j.ejpn.2017.01.012. Epub 2017 Feb 2.
The robotic-assisted gait training therapy (RAGT), based on intensity and repetition of movement, presents beneficial effects on recovery and improvement of postural and locomotor functions of the patient. This study sought to highlight the effect of this RAGT on the dynamic equilibrium control during walking in children with Cerebral Palsy (CP) by analyzing the different postural strategies of the fullbody (upper/lower body) before and after this RAGT in order to generate forward motion while maintaining balance. Data were collected by a motion analysis system (Vicon - Oxford Metrics). Thirty children with bilateral spastic CP were evaluated using a full-body marker set which allows assessing both the lower and upper limb kinematics. The children were divided into two groups in such a way as to obtain a randomized controlled population: i) a group of fourteen children (Treated Group) underwent 20 sessions of RAGT using the driven gait orthosis LokomatPediatric (Hocoma) compared to ii) a group of sixteen children without sessions of LokomatPediatric (Control Group) receiving only daily physiotherapy. Significant improvements are observed between the TG pre- and post-test values of i) the kinematic data of the full-body in the sagittal and frontal planes and ii) the Gross Motor Function Measure test (D and E). This study shows the usefulness of this RAGT mainly in the balance control in gait. Indeed, the Treated Group use new dynamic strategies of gait that are especially characterized by a more appropriate control of the upper body associated with an improvement of the lower limbs kinematics.
基于运动强度和重复次数的机器人辅助步态训练疗法（RAGT），对患者姿势和运动功能的恢复及改善具有有益效果。本研究旨在通过分析RAGT前后全身（上身/下身）不同的姿势策略，以突出这种RAGT对脑瘫（CP）儿童行走时动态平衡控制的影响，从而在保持平衡的同时产生向前运动。数据由运动分析系统（Vicon - Oxford Metrics）收集。使用全身标记集对30名双侧痉挛性CP儿童进行评估，该标记集可评估下肢和上肢的运动学。将儿童分为两组以获得随机对照人群：i）一组14名儿童（治疗组）使用驱动步态矫形器LokomatPediatric（Hocoma）进行20次RAGT治疗，相比之下ii）一组16名未接受LokomatPediatric治疗的儿童（对照组）仅接受每日物理治疗。在治疗组测试前和测试后的i）矢状面和额状面全身运动学数据以及ii）粗大运动功能测量测试（D和E）值之间观察到显著改善。本研究表明这种RAGT主要在步态平衡控制方面有用。事实上，治疗组采用了新的动态步态策略，其特点尤其在于对上半身进行更适当的控制，同时改善了下肢运动学。
