Itoh Norihide, Imoto Daisuke, Kubo Shuichi, Takahashi Kota, Hishikawa Norikazu, Mikami Yasuo, Kubo Toshikazu
Department of Advanced Rehabilitation, Kyoto Prefectural University of Medicine: 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan.
Department of Rehabilitation Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Japan.
J Phys Ther Sci. 2018 Aug;30(8):1046-1051. doi: 10.1589/jpts.30.1046. Epub 2018 Jul 24.
[Purpose] The Gait Exercise Assist Robot (GEAR) is a stationary, one-leg robot for gait training. The purpose of this case study was to evaluate the efficacy of rehabilitation using GEAR training for chronic stroke hemiplegia. [Participant and Methods] The participant was a 66-year-old male stroke survivor with left hemiparesis due to a right putaminal hemorrhage. He could walk slowly under supervision, although his gait had a constant forward trunk lean, with flexed knee, and a lack of hip extension movement on the affected side. Gait training using GEAR and physical therapy were performed for 14 days. Under both training conditions, the physical therapist made the participant conscious of extension movement of the hip joint in the affected-side stance phase. The robotic assistance was adjusted to maximize voluntary movement while observing gait. Physical function and gait ability parameters were evaluated before and after training. [Results] After training, extension motion of the hip joint increased in the affected-side stance phase, and body weight was transferred smoothly onto the affected-side limb, leading to an improvement in gait speed. [Conclusion] Gait training using GEAR and physical therapy may improve gait pattern and speed in patients with chronic stroke hemiplegia.
[目的] 步态训练辅助机器人(GEAR)是一种用于步态训练的固定式单腿机器人。本病例研究的目的是评估使用GEAR训练对慢性中风偏瘫进行康复治疗的效果。[参与者与方法] 参与者是一名66岁男性中风幸存者,因右侧壳核出血导致左侧偏瘫。他在监督下能够缓慢行走,但其步态存在持续的躯干前倾、膝关节屈曲以及患侧髋关节伸展运动不足的问题。使用GEAR进行步态训练并结合物理治疗,为期14天。在两种训练条件下,物理治疗师都让参与者在患侧站立期意识到髋关节的伸展运动。在观察步态时,调整机器人辅助以最大限度地增加自主运动。在训练前后评估身体功能和步态能力参数。[结果] 训练后,患侧站立期髋关节伸展运动增加,体重平稳地转移到患侧肢体上,从而使步态速度得到改善。[结论] 使用GEAR进行步态训练并结合物理治疗可能会改善慢性中风偏瘫患者的步态模式和速度。