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机器人辅助步态训练对运动不完全性脊髓损伤患者步态速度的改善:一项初步研究。

Improved Gait Speed After Robot-Assisted Gait Training in Patients With Motor Incomplete Spinal Cord Injury: A Preliminary Study.

作者信息

Hwang Seungwon, Kim Hye-Ri, Han Zee-A, Lee Bum-Suk, Kim Soojeong, Shin Hyunsoo, Moon Jae-Gun, Yang Sung-Phil, Lim Mun-Hee, Cho Duk-Youn, Kim Hayeon, Lee Hye-Jin

机构信息

Department of Rehabilitation Medicine, National Rehabilitation Center & Hospital, Seoul, Korea.

Translational Research Center for Rehabilitation Robots, National Rehabilitation Center & Hospital, Seoul, Korea.

出版信息

Ann Rehabil Med. 2017 Feb;41(1):34-41. doi: 10.5535/arm.2017.41.1.34. Epub 2017 Feb 28.

Abstract

OBJECTIVE

To evaluate the clinical features that could serve as predictive factors for improvement in gait speed after robotic treatment.

METHODS

A total of 29 patients with motor incomplete spinal cord injury received 4-week robot-assisted gait training (RAGT) on the Lokomat (Hocoma AG, Volketswil, Switzerland) for 30 minutes, once a day, 5 times a week, for a total of 20 sessions. All subjects were evaluated for general characteristics, the 10-Meter Walk Test (10MWT), the Lower Extremity Motor Score (LEMS), the Functional Ambulatory Category (FAC), the Walking Index for Spinal Cord Injury version II (WISCI-II), the Berg Balance Scale (BBS), and the Spinal Cord Independence Measure version III (SCIM-III) every 0, and 4 weeks. After all the interventions, subjects were stratified using the 10MWT score at 4 weeks into improved group and non-improved group for statistical analysis.

RESULTS

The improved group had younger age and shorter disease duration than the non-improved group. All subjects with the American Spinal Injury Association Impairment Scale level C (AIS-C) tetraplegia belonged to the non-improved group, while most subjects with AIS-C paraplegia, AIS-D tetraplegia, and AIS-D paraplegia belonged to the improved group. The improved group showed greater baseline lower extremity strength, balance, and daily living function than the non-improved group.

CONCLUSION

Assessment of SCIM-III, BBS, and trunk control, in addition to LEMS, have potential for predicting the effects of robotic treatment in patients with motor incomplete spinal cord injury.

摘要

目的

评估可作为机器人治疗后步态速度改善预测因素的临床特征。

方法

共有29例运动不完全性脊髓损伤患者在Lokomat(瑞士沃克茨维尔的Hocoma AG公司)上接受了为期4周的机器人辅助步态训练(RAGT),每次30分钟,每天1次,每周5次,共20节训练课。在第0周和第4周时,对所有受试者进行一般特征、10米步行测试(10MWT)、下肢运动评分(LEMS)、功能性步行分类(FAC)、脊髓损伤步行指数II版(WISCI-II)、伯格平衡量表(BBS)以及脊髓独立性测量III版(SCIM-III)的评估。所有干预结束后,根据4周时的10MWT评分将受试者分为改善组和未改善组进行统计分析。

结果

改善组的年龄比未改善组小,病程比未改善组短。所有美国脊髓损伤协会损伤量表C级(AIS-C)四肢瘫的受试者均属于未改善组,而大多数AIS-C截瘫、AIS-D四肢瘫和AIS-D截瘫的受试者属于改善组。改善组在基线时的下肢力量、平衡能力和日常生活功能均比未改善组更好。

结论

除了LEMS外,对SCIM-III、BBS和躯干控制能力的评估有可能预测机器人治疗对运动不完全性脊髓损伤患者的效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5193/5344824/e7602c764680/arm-41-34-g001.jpg

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