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机器人辅助运动训练未能改善慢性不完全性脊髓损伤患者的步行功能:一项随机临床试验。

Robot-assisted locomotor training did not improve walking function in patients with chronic incomplete spinal cord injury: A randomized clinical trial.

机构信息

Department of Health and Care, Arctic University of Norway, North Norway Rehabilitation Center, University of Tromsø, 9011 Tromsø, Norway.

出版信息

J Rehabil Med. 2019 May 13;51(5):385-389. doi: 10.2340/16501977-2547.

Abstract

OBJECTIVE

To assess the effects of robot-assisted locomotor training in patients with chronic incomplete spinal cord injury.

DESIGN

Randomized single-blind controlled clinical trial.

SETTING

The intervention site was an outpatient clinic, and pre- and post-evaluations were performed in a rehabilitation hospital.

PATIENTS

A total of 24 subjects with American Spinal Injury Association Impairment Scale grades C or D, >?2 years post-injury.

INTERVENTIONS

Subjects were randomized to 60 days of robot-assisted locomotor training, or to usual care.

METHODS

Walking function, lower extremity muscle strength and balance were assessed single-blinded pre- and post-intervention.

RESULTS

After a 9-year recruitment period, only 24 of the planned 30 subjects had been enrolled (mean time since injury 17 (standard deviation (SD) 20) years for all subjects). Walking function, lower extremity muscle strength and balance improved modestly in both groups, with no statistically significant group difference in walking function or muscle strength, whereas postural control declined significantly in the intervention group, compared with controls (p?=?0.03).

CONCLUSION

Late-onset robot-assisted locomotor training did not re-establish independent walking function. A modest, but non-significant, effect was seen on muscle strength and balance. However, significant between-group differences were found only in postural control in the control group.

摘要

目的

评估机器人辅助运动训练对慢性不完全性脊髓损伤患者的影响。

设计

随机单盲对照临床试验。

地点

干预地点为门诊,康复医院进行预评估和后评估。

患者

24 名美国脊髓损伤协会损伤分级 C 或 D 级、损伤后>2 年的患者。

干预

患者随机分为机器人辅助运动训练组或常规护理组,接受 60 天的治疗。

方法

单盲评估干预前后的步行功能、下肢肌肉力量和平衡。

结果

经过 9 年的招募期,仅纳入了计划中的 30 名患者中的 24 名(所有患者的损伤后平均时间为 17 年(标准差 20 年))。两组的步行功能、下肢肌肉力量和平衡都有一定程度的改善,但在步行功能或肌肉力量方面无统计学意义的组间差异,而干预组的姿势控制与对照组相比显著下降(p?=?0.03)。

结论

迟发性机器人辅助运动训练未能重新建立独立行走功能。在肌肉力量和平衡方面观察到适度但无统计学意义的效果。然而,仅在对照组中发现了姿势控制方面的显著组间差异。

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