Department of Orthopaedic Surgery, Ibaraki Prefectural University of Health Sciences Hospital, Ami 300-0331, Japan.
Center for Medical Sciences, Ibaraki Prefectural University of Health Sciences, Ami 300-0394, Japan.
Medicina (Kaunas). 2020 Dec 7;56(12):673. doi: 10.3390/medicina56120673.
Cerebral palsy (CP) is the most frequent childhood motor disability. Achieving ambulation or standing in children with CP has been a major goal of physical therapy. Recently, robot-assisted gait training using the Hybrid Assistive Limb (HAL) has been effective in improving walking ability in patients with CP. However, previous studies have not examined in detail the changes in gait pattern after HAL training for patients with spastic CP, including gait symmetry. This study aimed to evaluate the immediate effect of HAL training on the walking ability and the changes in gait pattern and gait symmetry in patients with spastic CP. : We recruited 19 patients with spastic CP (13 male and six female; mean age, 15.7 years). Functional ambulation was assessed using the 10-Meter Walk Test and gait analysis in the sagittal plane before and after a single 20-min HAL intervention session. The walking speed and stride length significantly increased after HAL intervention compared to the pre-intervention values. Two-dimensional gait analysis showed improvement in equinus gait, increase in the flexion angle of the swing phase in the knee and hip joints, and improvement in gait symmetry. Immediate improvements in the walking ability and gait pattern were noted after HAL training in patients with spastic CP. The symmetry of the joint angle of the lower limb, including the trunk, accounts for the improvement in walking ability after HAL therapy.
脑瘫（CP）是最常见的儿童运动障碍。让 CP 患儿实现行走或站立一直是物理治疗的主要目标。最近，使用混合辅助肢体（HAL）的机器人辅助步态训练在提高 CP 患者的行走能力方面已取得成效。然而，以前的研究并未详细检查 CP 痉挛型患者在 HAL 训练后的步态模式变化，包括步态对称性。本研究旨在评估 HAL 训练对痉挛型 CP 患者的行走能力以及步态模式和步态对称性变化的即时影响。：我们招募了 19 名痉挛型 CP 患者（13 名男性和 6 名女性；平均年龄 15.7 岁）。使用 10 米步行测试和矢状面步态分析在单次 20 分钟 HAL 干预前后评估功能性步行能力。与干预前相比，HAL 干预后行走速度和步长显著增加。二维步态分析显示马蹄内翻步态得到改善，膝关节和髋关节摆动阶段的屈曲角度增加，步态对称性得到改善。痉挛型 CP 患者在 HAL 训练后立即改善了行走能力和步态模式。下肢关节角度的对称性，包括躯干，解释了 HAL 治疗后行走能力的提高。
