Matsuda Mayumi, Mataki Yuki, Mutsuzaki Hirotaka, Yoshikawa Kenichi, Takahashi Kazushi, Enomoto Keiko, Sano Kumiko, Mizukami Masafumi, Tomita Kazuhide, Ohguro Haruka, Iwasaki Nobuaki
Department of Physical Therapy, Ibaraki Prefectural University of Health Sciences Hospital:4733 Ami, Ibaraki 300-0331, Japan.
Graduate School of Health Science, Ibaraki Prefectural University of Health Sciences, Japan.
J Phys Ther Sci. 2018 Feb;30(2):207-212. doi: 10.1589/jpts.30.207. Epub 2018 Feb 20.
[Purpose] Robot-assisted gait training (RAGT) using Hybrid Assistive Limb (HAL, CYBERDYNE) was previously reported beneficial for stroke and spinal cord injury patients. Here, we investigate the immediate effect of a single session of RAGT using HAL on gait function for cerebral palsy (CP) patients. [Subjects and Methods] Twelve patients (average age: 16.2 ± 7.3 years) with CP received a single session of RAGT using HAL. Gait speed, step length, cadence, single-leg support per gait cycle, hip and knee joint angle in stance, and swing phase per gait cycle were assessed before, during, and immediately after HAL intervention. [Results] Compared to baseline values, single-leg support per gait cycle (64.5 ± 15.8% to 69.3 ± 12.1%), hip extension angle in mid-stance (149.2 ± 19.0° to 155.5 ± 20.1°), and knee extension angle in mid-stance (137.6 ± 20.2° to 143.1 ± 19.5°) were significantly increased immediately after intervention. Further, the knee flexion angle in mid-swing was significantly decreased immediately after treatment (112.0 ± 15.5° to 105.2 ± 17.1°). Hip flexion angle in mid-swing also decreased following intervention (137.2 ± 14.6° to 129.7 ± 16.6°), but not significantly. Conversely, gait speed, step length, and cadence were unchanged after intervention. [Conclusion] A single-time RAGT with HAL improved single-leg support per gait cycle and hip and knee joint angle during gait, therapeutically improving gait function in CP patients.
[目的] 先前有报道称，使用混合辅助肢体（HAL，日本筑波大学附属筑波医院研发）进行机器人辅助步态训练（RAGT）对中风和脊髓损伤患者有益。在此，我们研究使用HAL进行单次RAGT对脑瘫（CP）患者步态功能的即时影响。[对象与方法] 12例CP患者（平均年龄：16.2±7.3岁）接受了单次使用HAL的RAGT训练。在HAL干预前、干预期间和干预后即刻，评估患者的步态速度、步长、步频、每个步态周期的单腿支撑时间、站立时髋膝关节角度以及每个步态周期的摆动相。[结果] 与基线值相比，干预后即刻每个步态周期的单腿支撑时间（从64.5±15.8%增至69.3±12.1%）、站立中期的髋关节伸展角度（从149.2±19.0°增至155.5±20.1°）以及站立中期的膝关节伸展角度（从137.6±20.2°增至143.1±19.5°）均显著增加。此外，治疗后即刻摆动中期的膝关节屈曲角度显著减小（从112.0±15.5°减至105.2±17.1°）。干预后摆动中期的髋关节屈曲角度也有所减小（从137.2±14.6°减至129.7±16.6°），但差异不显著。相反，干预后步态速度、步长和步频未发生变化。[结论] 使用HAL进行单次RAGT可改善每个步态周期的单腿支撑以及步态期间的髋膝关节角度，从而在治疗上改善CP患者的步态功能。
