Juszczak Michael, Gallo Estelle, Bushnik Tamara
Rusk Rehabilitation, NYU Langone Health, New York, New York.
Top Spinal Cord Inj Rehabil. 2018 Fall;24(4):336-342. doi: 10.1310/sci17-00055. Epub 2018 Aug 7.
Secondary impairments associated with spinal cord injury (SCI) limit one's independent functionality and negatively impact quality of life (QoL). The purpose of this study was to explore changes in secondary health conditions that may result from using a powered exoskeleton as well as their potential impact on QoL. Forty-five participants presenting with SCI ranging from T3-L2 were included in this study. Outcome measures included self-reported assessments of pain, spasticity, bladder/bowel function, Satisfaction with Life Scale (SWLS), and Modified Ashworth Scale (MAS). Participants reported significantly less spasticity at the conclusion of the study, 0.9 ± 1.7, compared to baseline, 1.6 ± 0.9 [ (44) = 2.83, < .001]. MAS testing revealed that 26.7% of participants presented with decreased spasticity at the conclusion of the trial. Participants reported less pain at the end of the trial, 0.9 ± 1.6, compared to the start, 1.1 ± 1.7 [ (44) = 1.42, > .05]. No negative changes in bowel and bladder were reported; positive changes were reported by 20% and 9% of participants with respect to bowel and bladder management. There was no statistically significant change in SWLS sum score from baseline, 20.4 ± 8.0, to conclusion of the study, 21.3 ± 7.6 [ (44) = -1.1, > .05]. Findings suggest using a powered exoskeleton may decrease spasticity in people living with SCI. Although improvements in secondary impairments did not result in a significant improvement in QoL, it is believed that using a powered exoskeleton in one's community will lead to increased community integration facilitating an improvement in QoL.
与脊髓损伤（SCI）相关的继发性损伤会限制患者的独立功能，并对生活质量（QoL）产生负面影响。本研究的目的是探讨使用动力外骨骼可能导致的继发性健康状况变化及其对生活质量的潜在影响。本研究纳入了45名胸3至腰2脊髓损伤的参与者。结果测量包括疼痛、痉挛、膀胱/肠道功能的自我报告评估、生活满意度量表（SWLS）和改良Ashworth量表（MAS）。与基线时的1.6±0.9相比，参与者在研究结束时报告的痉挛明显减少，为0.9±1.7[（44）=2.83，P<.001]。MAS测试显示，26.7%的参与者在试验结束时痉挛减轻。与开始时的1.1±1.7相比，参与者在试验结束时报告的疼痛较少，为0.9±1.6[（44）=1.42，P>.05]。未报告肠道和膀胱有负面变化；20%和9%的参与者报告在肠道和膀胱管理方面有积极变化。从基线时的20.4±8.0到研究结束时的21.3±7.6，SWLS总分无统计学显著变化[（44）=-1.1，P>.05]。研究结果表明，使用动力外骨骼可能会降低脊髓损伤患者的痉挛程度。虽然继发性损伤的改善并未导致生活质量的显著提高，但人们认为，在社区中使用动力外骨骼将增加社区融入度，从而促进生活质量的提高。
