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用于改善中风幸存者平衡和行走功能的 Kickstart 步行辅助系统:一项可行性研究。

The Kickstart Walk Assist System for improving balance and walking function in stroke survivors: a feasibility study.

机构信息

Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), Tongji University School of Medicine, Shanghai, China.

Department of Biomechanics, University of Nebraska at Omaha, Omaha, NE, USA.

出版信息

J Neuroeng Rehabil. 2021 Feb 24;18(1):42. doi: 10.1186/s12984-020-00795-y.

Abstract

BACKGROUND

Compared with traditional physical therapy for stroke patients, lower extremity exoskeletons can provide patients with greater endurance and more repeatable and controllable training, which can reduce the therapeutic burden of the therapist. However, most exoskeletons are expensive, heavy or require active power to be operated. Therefore, a lighter, easy to wear, easy to operate, low-cost technology for stroke rehabilitation would be a welcome opportunity for stroke survivors, caregivers and clinicians. One such device is the Kickstart Walk Assist system and the purpose of this study was to determine feasibility of using this unpowered exoskeleton device in a sample of stroke survivors.

METHODS

Thirty stroke survivors were enrolled in the study and experienced walking with the Kickstart exoskeleton device that provided spring-loaded assistance during gait. After 5 days of wearing the exoskeleton, participants were evaluated in the two states of wearing and not wearing the exoskeleton. Outcome measures included: (a) spatio-temporal gait measures, (b) balance measures and (c) exoskeleton-use feedback questionnaire.

RESULTS

In comparison to not wearing the device, when participants wore the Kickstart walking system, weight bearing asymmetry was reduced. The time spent on the 10-m walk test was also reduced, but there was no difference in the timed-up-and-go test (TUGT). Gait analysis data showed reduction in step time and double support time. Stroke survivors were positive about the Kickstart walking system's ability to improve their balance, speed and gait. In addition, their confidence level and willingness to use the device was also positive.

CONCLUSIONS

These findings show the feasibility of using the Kickstart walking system for improving walking performance in stroke survivors. Our future goal is to perform a longer duration study with more comprehensive pre- and post-testing in a larger sample of stroke survivors. Trial registration Chinese Clinical Trial Registry, ChiCTR2000032665. Registered 5 May 2020-Retrospectively registered, http://www.chictr.org.cn/showproj.aspx?proj=53288.

摘要

背景

与传统的脑卒中患者物理疗法相比,下肢外骨骼可以为患者提供更大的耐力和更可重复、更可控的训练,从而减轻治疗师的治疗负担。然而,大多数外骨骼设备昂贵、笨重或需要主动动力才能运行。因此,一种更轻、易于穿戴、易于操作、成本低廉的脑卒中康复技术将是脑卒中幸存者、护理人员和临床医生的一大福音。Kickstart Walk Assist 系统就是这样一种设备,本研究的目的是确定在脑卒中幸存者样本中使用这种无动力外骨骼设备的可行性。

方法

30 名脑卒中幸存者参加了这项研究,他们体验了在步态中提供弹簧加载辅助的 Kickstart 外骨骼设备的行走。在佩戴外骨骼 5 天后,参与者在佩戴和不佩戴外骨骼的两种状态下进行评估。评估指标包括:(a)时空步态测量、(b)平衡测量和(c)外骨骼使用反馈问卷。

结果

与不佩戴设备相比,当参与者佩戴 Kickstart 行走系统时,负重不对称性降低。10 米步行测试的时间也减少了,但计时起立行走测试(TUGT)没有差异。步态分析数据显示步时和双支撑时间减少。脑卒中幸存者对 Kickstart 行走系统改善平衡、速度和步态的能力给予了积极评价。此外,他们对该设备的信心水平和使用意愿也很积极。

结论

这些发现表明,在脑卒中幸存者中使用 Kickstart 行走系统来改善步行表现是可行的。我们未来的目标是在更大的脑卒中幸存者样本中进行更长时间的研究,并进行更全面的预测试和后测试。

试验注册

中国临床试验注册中心,ChiCTR2000032665。注册日期:2020 年 5 月 5 日-回顾性注册,http://www.chictr.org.cn/showproj.aspx?proj=53288。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ee0a/7905648/299108346899/12984_2020_795_Fig1_HTML.jpg

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