Wang R L, Zhou Z H, Xi Y C, Wang Q N, Wang N H, Huang Z
Department of Rehabilitation Medicine, Peking University First Hospital, Beijing 100034, China.
College of Engineering, Peking University, Beijing 100081, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2018 Apr 18;50(2):207-212.
To propose a kind of robotic ankle-foot rehabilitation system for children with cerebral palsy and to preliminarily verify its feasibility in clinical application.
A robot assisted ankle-foot rehabilitation system was specially designed and developed for children with cerebral palsy and a preliminary clinical study was conducted in Department of Rehabilitation Medicine, Peking University First Hospital. Modified Tardieu Scale and joint biomechanical properties (ankle plantar flexion resistance torque under different ankle dorsiflexion angles) were measured to analyze the muscle tone and soft tissue compliance of the ankle plantar flexors pre- and post-robotic training intervention. Six children with cerebral palsy (4 girls and 2 boys, mean age: 7 years) were recruited in this study. Each subject received 5 session robotic training and each session included 10-cycle passive stretching and static hold. SPSS 19.0 software was used for data statistical analysis.
Both R1 and R2 angles of Modified Tardieu Scale for ankle plantar flexors after training were significantly higher than those before the treatments (Gastrocnemius: P=0.003, P=0.029; Soleus: P=0.002, P=0.034). The difference between R2 and R1 was of no statistical difference before and after the training (P=0.067 and P=0.067, respectively). After training, the ankle plantar flexion resistance torque under different dorsiflexion angles (0°, 10°, 20°, 30°) were significantly reduced than those before training (P=0.001, P=0.001, P=0.014, P=0.002, respectively).
The robot assisted ankle-foot rehabilitation system can improve the contracture and soft tissue compliance of cerebral palsy children's ankle plantar flexors. All the children in the study were well tolerated and interested with the training, easy to accept and cooperate with it. This device may be suitable for application in the rehabilitation of children with cerebral palsy. However, further randomized clinical trials with larger sample size are still needed to verify the long term efficacy of this device.
提出一种针对脑瘫儿童的机器人踝足康复系统，并初步验证其在临床应用中的可行性。
专门为脑瘫儿童设计并开发了一种机器人辅助踝足康复系统，并在北京大学第一医院康复医学科进行了初步临床研究。测量改良Tardieu量表和关节生物力学特性（不同踝关节背屈角度下的踝关节跖屈阻力矩），以分析机器人训练干预前后踝关节跖屈肌的肌张力和软组织顺应性。本研究招募了6名脑瘫儿童（4名女孩和2名男孩，平均年龄：7岁）。每个受试者接受5次机器人训练，每次训练包括10个周期的被动拉伸和静态保持。使用SPSS 19.0软件进行数据统计分析。
训练后踝关节跖屈肌改良Tardieu量表的R1和R2角度均显著高于治疗前（腓肠肌：P = 0.003，P = 0.029；比目鱼肌：P = 0.002，P = 0.034）。训练前后R2与R1之间的差异无统计学意义（分别为P = 0.067和P = 0.067）。训练后，不同背屈角度（0°、10°、20°、30°）下的踝关节跖屈阻力矩均显著低于训练前（分别为P = 0.001、P = 0.001、P = 0.014、P = 0.002）。
机器人辅助踝足康复系统可改善脑瘫儿童踝关节跖屈肌的挛缩和软组织顺应性。研究中的所有儿童对训练耐受性良好且感兴趣，易于接受并配合训练。该设备可能适用于脑瘫儿童的康复。然而，仍需要进一步进行更大样本量的随机临床试验来验证该设备的长期疗效。
