Ishibashi Kiyoshige, Yoshikawa Kenichi, Koseki Kazunori, Aoyama Toshiyuki, Ishii Daisuke, Yamamoto Satoshi, Matsuda Tomoyuki, Tomita Kazuhide, Mutsuzaki Hirotaka, Kohno Yutaka
Department of Physical Therapy, Ibaraki Prefectural University of Health Sciences Hospital, Ibaraki, Japan.
Department of Physical Therapy, School of Health Sciences, Ibaraki Prefectural University of Health Sciences, Ibaraki, Japan.
Prog Rehabil Med. 2021 Sep 16;6:20210037. doi: 10.2490/prm.20210037. eCollection 2021.
Conventional rehabilitation is known to improve walking ability after stoke, but its effectiveness is often limited. Recent studies have shown that gait training combining conventional rehabilitation and robotic devices in stroke patients provides better results than conventional rehabilitation alone, suggesting that gait training with a robotic device may lead to further improvements in the walking ability recovered by conventional rehabilitation. Therefore, the aim of this report was to highlight the changes in kinematic and electromyographic data recorded during walking before and after gait training with the Honda Walking Assist Device (HWAT) in a male patient whose walking speed had reached a recovery plateau under conventional rehabilitation.
The patient was a 42-year-old man with severe hemiplegia caused by right putaminal hemorrhage. He underwent conventional rehabilitation for 20 weeks following the onset of stroke, after which his walking speed reached a recovery plateau. Subsequently, we added robotic rehabilitation using HWAT to his regular rehabilitation regimen, which resulted in improved step length symmetry and gait endurance. We also noted changes in muscle activity patterns during walking.
HWAT further improved the walking ability of a patient who had recovered with conventional rehabilitation; this improvement was accompanied by changes in muscle activity patterns during walking. The improvement in gait endurance exceeded the smallest meaningful change in stroke patients, suggesting that this improvement represented a noticeable enhancement in the quality of life in relation to mobility in the community. Further clinical trials are needed to confirm the results of the present case study.
众所周知，传统康复可改善中风后的步行能力，但其效果往往有限。最近的研究表明，中风患者将传统康复与机器人设备相结合的步态训练比单纯的传统康复效果更好，这表明使用机器人设备进行步态训练可能会进一步改善通过传统康复恢复的步行能力。因此，本报告的目的是突出一名男性患者在使用本田步行辅助装置（HWAT）进行步态训练前后行走过程中记录的运动学和肌电图数据的变化，该患者在传统康复下步行速度已达到恢复平台期。
该患者为一名42岁男性，因右侧壳核出血导致严重偏瘫。中风发作后，他接受了20周的传统康复治疗，之后步行速度达到恢复平台期。随后，我们在其常规康复方案中增加了使用HWAT的机器人康复训练，结果步长对称性和步态耐力得到改善。我们还注意到行走过程中肌肉活动模式的变化。
HWAT进一步改善了一名通过传统康复已恢复的患者的步行能力；这种改善伴随着行走过程中肌肉活动模式的变化。步态耐力的改善超过了中风患者最小有意义变化，这表明这种改善代表了社区中与行动能力相关的生活质量的显著提高。需要进一步的临床试验来证实本病例研究的结果。
