S. Anna Institute, 88900, Crotone, Italy.
Department of Life, Health and Environmental Sciences, University of L'Aquila, Italy.
Gait Posture. 2020 Oct;82:287-293. doi: 10.1016/j.gaitpost.2020.09.020. Epub 2020 Sep 29.
The aim of this study was to determine the effectiveness of a novel body-weight-supported (BWS) gait training system with visual feedback, called Copernicus® (Rehalife, Italy). This computerized device provides comfortable, regular and repeatable locomotion in hemiplegic patients. Through visual real-time monitoring of gait parameters, patients are trained to transfer weight loading alternately on both feet.
A single-blind, randomized controlled study. A single center used a computer-generated randomization code to allocate treatments.
Intensive rehabilitation unit (IRU) at the Institute S. Anna (Italy).
63 first-ever stroke patients (39 men, age: 66.1 ± 9.6 years; 61.6 % with left-sided lesion) randomly distributed into three demographically/clinically matched groups.
All groups were treated five times a week for 2 -h sessions for six consecutive weeks. The first group ("control") underwent a conventional physical therapy; the second group performed advanced BWS gait training sessions without visual feedback (Experimental VF- group); whereas the third group used BWS with visual feedback stimulation (Experimental VF+ group).
Absolute changes were recorded using conventional clinical scales and kinematic measurement of static gait balance from baseline to follow-up.
Significant interaction Group*Time effects scales (F = 5.1, p-level = 0.005, η² = 0.25; F = 4.7, p-level = 0.007, η² = 0.19; respectively) were detected in the Functional Independence Measure and Tinetti-Balance scales. Post hoc analysis demonstrated that the recovery of motor functioning was greater for the VF + group with respect to other groups (all p's ≤ 0.001). A similar pattern of findings was also obtained with a stabilometric analysis, demonstrating a better clinical improvement in static balance after VF + treatment.
The proposed advanced rehabilitation system with visual feedback was more effective in improving gait recovery with respect to conventional and high-tech therapies without a sensor feedback.
本研究旨在评估新型减重支持(BWS)步态训练系统(Copernicus ® ,Rehalife,意大利)的有效性。该计算机设备可使偏瘫患者进行舒适、规律和可重复的运动。通过实时监测步态参数,患者可以训练交替双脚承重。
单盲、随机对照研究。一个中心使用计算机生成的随机化代码分配治疗。
圣安娜研究所(意大利)强化康复单元(IRU)。
63 例首次脑卒中患者(39 例男性,年龄:66.1 ± 9.6 岁;61.6%为左侧病变)随机分为三组,具有相似的人口统计学和临床特征。
所有患者每周接受 5 次、每次 2 小时的治疗,持续 6 周。第一组(“对照组”)接受常规物理治疗;第二组进行无视觉反馈的高级 BWS 步态训练(实验 VF- 组);而第三组则使用带视觉反馈刺激的 BWS(实验 VF+ 组)。
采用常规临床量表和静态步态平衡的运动学测量,从基线到随访记录绝对变化。
在功能独立性测量和 Tinetti-平衡量表上均检测到组间*时间交互作用的显著效果(F = 5.1,p 水平 = 0.005,η² = 0.25;F = 4.7,p 水平 = 0.007,η² = 0.19)。事后分析表明,VF+组的运动功能恢复优于其他组(所有 p 值均≤0.001)。平衡仪分析也得到了类似的发现,表明 VF+治疗后静态平衡的临床改善更好。
与无传感器反馈的传统和高科技治疗相比,带有视觉反馈的新型高级康复系统在改善步态恢复方面更有效。