China Rehabilitation Research Center, Beijing Bo'ai Hospital, Capital Medical University School of Rehabilitation Medicine, Beijing, China.
NeuroRehabilitation. 2022;51(3):499-508. doi: 10.3233/NRE-220124.
Spinal cord injury (SCI) results in neurological dysfunction of the spinal cord below the injury.
To explore the immediate and long-term effects of robotic-assisted gait training (RAGT) on the recovery of motor function and walking ability in children with thoracolumbar incomplete SCI.
Twenty-one children with thoracolumbar incomplete SCI were randomly divided into the experimental (n = 11) and control groups (n = 10). The control group received 60 min of conventional physical therapy, and the experimental group received 30 min of RAGT based on 30 minutes of conventional physical therapy. Changes in walking speed and distance, physiological cost index (PCI), lower extremity motor score (LEMS), SCI walking index and centre-of-pressure (COP) envelope area score were observed in both groups of children before and after eight weeks of training. The primary outcome measures were the 10-metre walk test (10MWT) and six-minute walk distance (6MWD) at preferred and maximal speeds. In addition, several other measures were assessed, such as postural control and balance, lower limb strength and energy expenditure.
Compared with control group, the self-selected walk speed (SWS), maximum walking speed (MWS), 6MWD, PCI, LEMS, COP, and Walking Index for Spinal Cord injury II (WISCI II) of experimental group were improved after treatment. The 6MWD, PCI, COP, and WISCI II after eight weeks of treatment were improved in experimental group. All indicators were not identical at three different time points when compared between two groups. Pairwise comparisons in experimental group suggested that the SWS, MWS, 6MWD, PCI, LEMS, COP, and WISCI II after treatment were higher than those before treatment. The 6MWD, LEMS, COP, and WISCI II after treatment were higher than at the one-month follow-up appointment. The SWS, PCI, LEMS, COP, and WISCI II at the eight-week follow-up appointment were improved.
Robotic-assisted gait training may significantly improve the immediate motor function and walking ability of children with thoracolumbar incomplete SCI.
脊髓损伤（SCI）导致损伤以下脊髓的神经功能障碍。
探讨机器人辅助步态训练（RAGT）对胸腰段不完全性 SCI 儿童运动功能和步行能力恢复的即时和长期影响。
将 21 例胸腰段不完全性 SCI 患儿随机分为实验组（n=11）和对照组（n=10）。对照组接受 60 分钟常规物理治疗，实验组在接受 30 分钟常规物理治疗的基础上，增加 30 分钟 RAGT。观察两组患儿训练前、后 8 周行走速度和距离、生理成本指数（PCI）、下肢运动评分（LEMS）、脊髓损伤步行指数（WISCI）和中心压力（COP）包络面积评分的变化。主要观察指标为 10 米步行测试（10MWT）和 6 分钟步行距离（6MWD）的最佳和最大速度。此外，还评估了其他几个指标，如姿势控制和平衡、下肢力量和能量消耗。
与对照组相比，实验组的自我选择步行速度（SWS）、最大步行速度（MWS）、6MWD、PCI、LEMS、COP 和 WISCI II 均在治疗后有所改善。实验组治疗 8 周后 6MWD、PCI、COP 和 WISCI II 均有所改善。两组间三个不同时间点的所有指标均不相同。实验组的 SWS、MWS、6MWD、PCI、LEMS、COP 和 WISCI II 均较治疗前提高，治疗后 6MWD、LEMS、COP 和 WISCI II 均较治疗后 1 个月提高，治疗后 8 周的 SWS、PCI、LEMS、COP 和 WISCI II 均有所提高。
机器人辅助步态训练可显著改善胸腰段不完全性 SCI 患儿的即时运动功能和步行能力。
