Swank Chad, Trammell Molly, Bennett Monica, Ochoa Christa, Callender Librada, Sikka Seema, Driver Simon
Baylor Scott & White Institute for Rehabilitation.
Baylor Scott & White Health, Dallas, Texas, USA.
Int J Rehabil Res. 2020 Sep;43(3):206-213. doi: 10.1097/MRR.0000000000000409.
Overground robotic exoskeleton gait training is increasingly utilized during inpatient rehabilitation yet without clear guidelines. We describe clinical characteristics associated with robotic exoskeleton gait training and examine outcomes of people with spinal cord injury and stroke who completed usual rehabilitation care with or without robotic exoskeleton gait training. Retrospective review of medical records over a 36 months period. Inpatients with spinal cord injury or stroke and ≥1 robotic exoskeleton gait training session were included. After obtaining a complete list of robotic exoskeleton gait training participants, medical records were reviewed for comparable matches as determined by gait functional independence measure score <4, age 18-100 years, meeting exoskeleton manufacturer eligibility criteria, and participating in usual care only. Functional independence measure was collected on all patients. For spinal cord injury, we collected the walking index for spinal cord injury II. For stroke, we collected the Stroke Rehabilitation Assessment of Movement Measure. Fifty-nine people with spinal cord injury (n = 31 robotic exoskeleton gait training; n = 28 usual care) and 96 people post-stroke (n = 44 robotic exoskeleton gait training; n = 52 usual care) comprised the medical record review. Fifty-eight percent of patients with spinal cord injury and 56% of patients post-stroke completed 5+ robotic exoskeleton gait training sessions and were included in analyses. Robotic exoskeleton gait training dosage varied between our patients with spinal cord injury and patients post-stroke. Robotic exoskeleton gait training utilization during inpatient rehabilitation required consideration of unique patient characteristics impacting functional outcomes. Application of robotic exoskeleton gait training across diagnoses may require different approaches during inpatient rehabilitation.
地面机器人外骨骼步态训练在住院康复期间的应用越来越广泛，但尚无明确的指导方针。我们描述了与机器人外骨骼步态训练相关的临床特征，并研究了脊髓损伤和中风患者在接受或未接受机器人外骨骼步态训练的情况下完成常规康复护理后的结果。对36个月期间的病历进行回顾性分析。纳入脊髓损伤或中风且接受过≥1次机器人外骨骼步态训练的住院患者。在获得机器人外骨骼步态训练参与者的完整名单后，对病历进行审查，以寻找步态功能独立性测量得分<4、年龄在18至100岁之间、符合外骨骼制造商资格标准且仅接受常规护理的可比匹配对象。对所有患者进行功能独立性测量。对于脊髓损伤患者，我们收集了脊髓损伤步行指数II。对于中风患者，我们收集了运动测量中风康复评估。59例脊髓损伤患者（n = 31接受机器人外骨骼步态训练；n = 28接受常规护理）和96例中风后患者（n = 44接受机器人外骨骼步态训练；n = 52接受常规护理）纳入病历审查。58%的脊髓损伤患者和56%的中风后患者完成了5次以上的机器人外骨骼步态训练，并纳入分析。我们的脊髓损伤患者和中风后患者之间的机器人外骨骼步态训练剂量有所不同。住院康复期间机器人外骨骼步态训练的应用需要考虑影响功能结果的独特患者特征。在住院康复期间，跨诊断应用机器人外骨骼步态训练可能需要不同的方法。
