Lamberti Gianfranco, Sesenna Gianluca, Marina Martina, Ricci Emanuela, Ciardi Gianluca
Spinal Unit, Azienda Usl, 29121 Piacenza, Italy.
Degree Course of Physiotherapy, University of Parma-Piacenza Training Center, Viale Abruzzo 12, 29017 Fiorenzuola d'Arda, Italy.
Neurol Int. 2022 Jun 22;14(3):561-573. doi: 10.3390/neurolint14030045.
Ataxia is a neurological sign characterized by motor coordination during gait/voluntary limb movements impairment. Ataxic gait leads to disability and worsening of quality of life; physiotherapy intervention is recommended to improve motor function. Recent studies showed benefits due to repetitive robotized assisted gait training using a static exoskeleton in patients affected by acquired ataxias. The aim of the study was to perform a preliminary evaluation of the short-term effects of overground UAN.GO-assisted gait training in an adult patient with ataxia but with no clear genetic pattern.
This case report study was conducted on a single male adult patient, who presented ataxic spastic gait, posterior chain tightness, pes cavus, and unstable standing position. The patient underwent two preliminary sessions to take part in the study. Treatment protocol planned 10 sessions and each one lasted 80 min, 60 of which were spent in gait training using the mobile overground exoskeleton UAN.GO. At T1 (start of the study) and T10 (final evaluation) assessments using the Scale for the Assessment and Rating of Ataxia, Berg Balance Scale, 6-Minute Walking Test, and Likert Scale were administered. Space-time parameters of gait cycle were also evaluated: left and right step length, stance and swing percentages.
improvements on the Scale for the Assessment and Rating of Ataxia, Berg Balance Scale, and in the distance travelled at 6-Minute Walking Test emerged. The patient gave a positive opinion towards the treatment, showed by Likert Scale results. Kinematic gait analysis showed more physiological step length, stance and swing percentages, joint angles. The patient completed the training program with an excellent compliance.
Since these encouraging outcomes were obtained, it is possible to consider robot-assisted gait training performed with UAN.GO as a therapeutic option to improve motor and functional performance in patients with ataxic gait.
共济失调是一种神经学体征，其特征为步态/肢体自主运动时的运动协调性受损。共济失调步态会导致残疾并使生活质量恶化；建议采用物理治疗干预来改善运动功能。最近的研究表明，对于后天性共济失调患者，使用静态外骨骼进行重复性机器人辅助步态训练有益。本研究的目的是对一名无明确遗传模式的成年共济失调患者进行地面UAN.GO辅助步态训练的短期效果进行初步评估。
本病例报告研究针对一名成年男性患者开展，该患者表现出共济失调性痉挛步态、后链紧张、高弓足和站立姿势不稳。患者参加了两次预备课程以参与本研究。治疗方案计划进行10次课程，每次持续80分钟，其中60分钟用于使用地面移动外骨骼UAN.GO进行步态训练。在T1（研究开始时）和T10（最终评估）时，使用共济失调评估与评分量表、伯格平衡量表、6分钟步行试验和李克特量表进行评估。还评估了步态周期的时空参数：左右步长、支撑期和摆动期百分比。
共济失调评估与评分量表、伯格平衡量表以及6分钟步行试验中的行走距离均有改善。李克特量表结果显示患者对治疗给予了积极评价。运动步态分析显示步长、支撑期和摆动期百分比以及关节角度更符合生理状态。患者以极高的依从性完成了训练计划。
鉴于取得了这些令人鼓舞的结果，可以考虑将使用UAN.GO进行的机器人辅助步态训练作为改善共济失调步态患者运动和功能表现的一种治疗选择。
