Kotov S V, Lijdvoy V Yu, Sekirin A B, Petrushanskaya K A, Pismennaya E V
Vladimirsky Moscow Regional Research Clinical Institute, Moscow, Russia.
ExoAtlet, Moscow, Russia.
Zh Nevrol Psikhiatr Im S S Korsakova. 2017;117(10. Vyp. 2):41-47. doi: 10.17116/jnevro201711710241-47.
To investigate the efficacy and safety of the exoskeleton ExoAtlet in complex therapy of patients with multiple sclerosis (MS).
A pilot study within the prospective open controlled program was conducted. Eighteen patients with relapsing-remitting MS (RRMS) in remission and secondary progressive MS (SPMS) with the level of neurological deficit on the EDSS from 3 to 7 points have completed the study. EDSS, MSFC, HADS, MoCA scales were administered and the force measuring insoles F-Scan Tekscan (USA) were used to study the biomechanics of walking.
Good tolerability of workload within 30-40 min. was observed. The improvement in the EDSS was detected in 9 patients, in whole, a significant positive trend (p<0.01) was shown. The study of the biomechanics of the walk showed its significant impairment compared to healthy individuals: reduction of parameters of rate, speed and step length, significant instability, pronounced asymmetry, the decrease in support and shock lower limb function, high coefficient of variability of the parameters, the phenomenon of recurrence of the vertical component of support reactions. After a course of exercise of walking in the exoskeleton, the walking speed and stability increased, oscillation of the body decreased, support function increased, the phenomenon of cyclical changes of the vertical component of support reactions reduced. The results of the pilot study showed promising future research opportunities for robotic-assisted walking and maintenance of the vertical posture with the help of the exoskeleton ExoAtlet to restore the abilities of movement in MS patients with locomotor disorders.
研究外骨骼ExoAtlet在多发性硬化症（MS）患者综合治疗中的疗效和安全性。
在一项前瞻性开放对照项目中进行了一项试点研究。18例缓解期复发缓解型MS（RRMS）和继发进展型MS（SPMS）患者完成了该研究，这些患者的扩展残疾状态量表（EDSS）神经功能缺损水平为3至7分。使用了EDSS、MS功能复合量表（MSFC）、医院焦虑抑郁量表（HADS）、蒙特利尔认知评估量表（MoCA），并采用美国F-Scan Tekscan测力鞋垫研究步行生物力学。
观察到患者在30 - 40分钟内对工作量具有良好的耐受性。9例患者的EDSS有所改善，总体呈现出显著的积极趋势（p<0.01）。步行生物力学研究表明，与健康个体相比，患者存在明显的损害：步频、速度和步长参数降低，明显不稳定，明显不对称，下肢支撑和减震功能下降，参数变异系数高，支撑反应垂直分量出现反复现象。经过外骨骼步行训练课程后，步行速度和稳定性提高，身体摆动减少，支撑功能增强，支撑反应垂直分量的周期性变化现象减少。试点研究结果显示，未来利用外骨骼ExoAtlet进行机器人辅助步行和维持垂直姿势以恢复MS运动障碍患者运动能力的研究具有广阔前景。
