帕金森病患者的机器人辅助步态训练：对临床实践的启示。一项系统综述。
Robot-assisted gait training in patients with Parkinson's disease: Implications for clinical practice. A systematic review.
作者信息
Carmignano Simona Maria, Fundarò Cira, Bonaiuti Donatella, Calabrò Rocco Salvatore, Cassio Anna, Mazzoli Davide, Bizzarini Emiliana, Campanini Isabella, Cerulli Simona, Chisari Carmelo, Colombo Valentina, Dalise Stefania, Gazzotti Valeria, Mazzoleni Daniele, Mazzucchelli Miryam, Melegari Corrado, Merlo Andrea, Stampacchia Giulia, Boldrini Paolo, Mazzoleni Stefano, Posteraro Federico, Benanti Paolo, Castelli Enrico, Draicchio Francesco, Falabella Vincenzo, Galeri Silvia, Gimigliano Francesca, Grigioni Mauro, Mazzon Stefano, Molteni Franco, Morone Giovanni, Petrarca Maurizio, Picelli Alessandro, Senatore Michele, Turchetti Giuseppe, Andrenelli Elisa
机构信息
Centro Terapeutico Riabilitativo (CTR), Potenza, Italy.
University of Salerno, Salerno, Italy.
出版信息
NeuroRehabilitation. 2022;51(4):649-663. doi: 10.3233/NRE-220026.
BACKGROUND
Gait impairments are common disabling symptoms of Parkinson's disease (PD). Among the approaches for gait rehabilitation, interest in robotic devices has grown in recent years. However, the effectiveness compared to other interventions, the optimum amount of training, the type of device, and which patients might benefit most remains unclear.
OBJECTIVE
To conduct a systematic review about the effects on gait of robot-assisted gait training (RAGT) in PD patients and to provide advice for clinical practice.
METHODS
A search was performed on PubMed, Scopus, PEDro, Cochrane library, Web of science, and guideline databases, following PRISMA guidelines. We included English articles if they used a robotic system with details about the intervention, the parameters, and the outcome measures. We evaluated the level and quality of evidence.
RESULTS
We included twenty papers out of 230 results: two systematic reviews, 9 randomized controlled trials, 4 uncontrolled studies, and 5 descriptive reports. Nine studies used an exoskeleton device and the remainders end-effector robots, with large variability in terms of subjects' disease-related disability.
CONCLUSIONS
RAGT showed benefits on gait and no adverse events were recorded. However, it does not seem superior to other interventions, except in patients with more severe symptoms and advanced disease.
背景
步态障碍是帕金森病（PD）常见的致残症状。在步态康复方法中，近年来对机器人设备的兴趣日益增加。然而，与其他干预措施相比其有效性、最佳训练量、设备类型以及哪些患者可能受益最大仍不明确。
目的
对机器人辅助步态训练（RAGT）对PD患者步态的影响进行系统评价，并为临床实践提供建议。
方法
按照PRISMA指南，在PubMed、Scopus、PEDro、Cochrane图书馆、科学网和指南数据库中进行检索。如果英文文章使用了机器人系统并包含干预细节、参数和结局指标，则将其纳入。我们评估了证据的水平和质量。
结果
我们从230个结果中纳入了20篇论文：2篇系统评价、9项随机对照试验、4项非对照研究和5篇描述性报告。9项研究使用了外骨骼设备，其余使用末端执行器机器人，受试者与疾病相关的残疾程度差异很大。
结论
RAGT对步态有改善作用，且未记录到不良事件。然而，除了症状更严重和疾病晚期的患者外，它似乎并不优于其他干预措施。
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