Wu Ming, Kim Janis, Gaebler-Spira Deborah J, Schmit Brian D, Arora Pooja
Sensory Motor Performance Program, Rehabilitation Institute of Chicago, Chicago, IL; Northwestern University Medical School, Chicago, IL.
Sensory Motor Performance Program, Rehabilitation Institute of Chicago, Chicago, IL.
Arch Phys Med Rehabil. 2017 Nov;98(11):2126-2133. doi: 10.1016/j.apmr.2017.04.022. Epub 2017 May 30.
To determine whether applying controlled resistance forces to the legs during the swing phase of gait may improve the efficacy of treadmill training as compared with applying controlled assistance forces in children with cerebral palsy (CP).
Randomized controlled study.
Research unit of a rehabilitation hospital.
Children with spastic CP (N=23; mean age, 10.6y; range, 6-14y; Gross Motor Function Classification System levels, I-IV).
Participants were randomly assigned to receive controlled assistance (n=11) or resistance (n=12) loads applied to the legs at the ankle. Participants underwent robotic treadmill training 3 times a week for 6 weeks (18 sessions). A controlled swing assistance/resistance load was applied to both legs starting from the toe-off to mid-swing phase of gait during training.
Outcome measures consisted of overground walking speed, 6-minute walk distance, and Gross Motor Function Measure scores and were assessed pre and post 6 weeks of training and 8 weeks after the end of training.
After 6 weeks of treadmill training in participants from the resistance training group, fast walking speed and 6-minute walk distance significantly improved (18% and 30% increases, respectively), and 6-minute walk distance was still significantly greater than that at baseline (35% increase) 8 weeks after the end of training. In contrast, overground gait speed and 6-minute walk distance had no significant changes after robotic assistance training.
The results of the present study indicated that robotic resistance treadmill training is more effective than assistance training in improving locomotor function in children with CP.
确定在脑瘫（CP）患儿步态摆动期对其腿部施加可控阻力与施加可控助力相比，是否可提高跑步机训练的效果。
随机对照研究。
一家康复医院的研究单位。
痉挛型CP患儿（N = 23；平均年龄10.6岁；范围6 - 14岁；粗大运动功能分类系统水平，I - IV级）。
参与者被随机分配接受在脚踝处对腿部施加可控助力（n = 11）或阻力（n = 12）负荷。参与者每周进行3次机器人跑步机训练，共6周（18节）。训练期间，从步态蹬离期到摆动中期，对双腿施加可控的摆动助力/阻力负荷。
结局指标包括地面行走速度、6分钟步行距离和粗大运动功能测量得分，在训练6周前后以及训练结束后8周进行评估。
阻力训练组参与者经过6周跑步机训练后，快走速度和6分钟步行距离显著提高（分别增加18%和30%），训练结束8周后，6分钟步行距离仍显著大于基线水平（增加35%）。相比之下，机器人助力训练后地面步态速度和6分钟步行距离无显著变化。
本研究结果表明，机器人阻力跑步机训练在改善CP患儿运动功能方面比助力训练更有效。
