Kotov S V, Isakova E V, Lijdvoy V Yu, Petrushanskaya K A, Pismennaya E V, Romanova M V, Kodzokova L H
Vladimirsky Moscow Regional Research Clinical Institute, Moscow, Russia.
Research Institute of Mechanics of Moscow State University, Moscow, Russia.
Zh Nevrol Psikhiatr Im S S Korsakova. 2020;120(8. Vyp. 2):73-80. doi: 10.17116/jnevro202012008273.
To compare the efficacy of walking function recovery in patients in the early recovery period of ischemic stroke (IS) using an exoskeleton for the lower extremities and an active-passive pedal exercise bike.
An open randomized study of 47 patients in the early recovery period of IS was conducted. The rehabilitation course included exercises on an ExoAtlet exoskeleton in group 1 and exercises on a pedal simulator for active-passive training (5 days a week for 2 weeks) in group 2. Several tests were used to evaluate treatment results, including the Hauser walking index, the 10-meter walking test, the Berg balance scale, stabilometry, and biomechanics of walking. The complete training course was completed by 20 patients of group 1 and 21 of group 2.
There was a significant increase in strength in paretic muscles, postural stability, functional level and walking speed in patients of both groups, but in patients of group 1, the dynamics of recovery was more pronounced (<0.05). In group 1, there was a significant decrease in the level of disability and an increase in daily activity, which was higher compared to group 2. An analysis of the main indicators of the statokinesiogram showed the more pronounced positive shifts in patients of group 1, but significant differences were found only in the dynamics of the length and area of the curve in the test with eyes open. When studying the biomechanics of walking, it was found that the function of walking was changed: there was a significant decrease in the speed of movement by 2.2 times, the length of a double step by 1.6 times, and the pace of walking by 1.3 times compared to normal indicators. After the end of exercises, a significant increase in the length of the double step, speed and pace of walking as well as a decrease in the period of the locomotor cycle were found in group 1.
The study revealed a positive impact of hardware rehabilitation on locomotion, both with the use of an exoskeleton and an active-passive pedal simulator. The use of an exoskeleton, have the advantages resulting in a significantly greater recovery of strength, stability, speed and symmetry of walking over the same period of training. A significant increase in postural stability in vertical position was revealed.
比较使用下肢外骨骼和主动-被动式脚踏运动自行车对缺血性脑卒中（IS）早期恢复期患者步行功能恢复的疗效。
对47例IS早期恢复期患者进行了一项开放性随机研究。康复疗程包括第1组在ExoAtlet外骨骼上进行的训练以及第2组在用于主动-被动训练的脚踏模拟器上进行的训练（每周5天，共2周）。使用了多项测试来评估治疗效果，包括豪泽步行指数、10米步行测试、伯格平衡量表、静态姿势分析以及步行生物力学分析。第1组的20例患者和第2组的21例患者完成了整个训练疗程。
两组患者患侧肌肉力量、姿势稳定性、功能水平和步行速度均有显著提高，但第1组患者的恢复动态更为明显（<0.05）。第1组患者的残疾程度显著降低，日常活动能力增强，且高于第2组。对静态姿势图主要指标的分析显示，第1组患者的积极变化更为明显，但仅在睁眼测试中曲线长度和面积的动态变化方面发现了显著差异。在研究步行生物力学时发现，步行功能发生了改变：与正常指标相比，运动速度显著降低2.2倍，双步长度降低1.6倍，步行步幅降低1.3倍。训练结束后，第1组患者的双步长度、步行速度和步幅显著增加，运动周期时长缩短。
该研究揭示了硬件康复对运动功能的积极影响，无论是使用外骨骼还是主动-被动式脚踏模拟器。使用外骨骼具有优势，在相同训练期间能使步行力量、稳定性、速度和对称性得到显著更大程度的恢复。研究还发现垂直位姿势稳定性显著提高。
