From the School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China (Y-HZ, MR, R-SY, Y-X Zhong, Y-X Zhang, Y-JW, J-WC); and Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China (Y-JW, Y-LS).
Am J Phys Med Rehabil. 2023 Apr 1;102(4):331-339. doi: 10.1097/PHM.0000000000002098. Epub 2022 Sep 3.
The aim of the study is to systematically review the effects of leg-driven treadmill-based exoskeleton robot training on balance and walking ability in poststroke patients.
The PubMed, Cochrane Library, Embase, Web of Science, Medline, CNKI, VIP, and Wanfang databases were searched from inception to August 2021. The literature quality was evaluated using Cochrane Handbook. Primary outcomes include the Functional Ambulation Category Scale and Berg Balance Scale, and secondary outcomes include the 10 meter walk test, 6 minute walk test, and gait assessment cadence were analyzed.
Seventeen randomized controlled trials were included in the systematic review, 15 studies in meta-analysis. Primary outcomes showed no significant difference in the Functional Ambulation Category Scale score; subgroup with the exoskeleton robot + conventional therapy of the Berg Balance Scale score was significantly increased; secondary outcomes showed no significance in 6 minute walk test or 10 meter walk test. The cadence score increased for the subgroup with an onset of more than 6 mos in the treatment group. The control group performed better than the subgroup with an onset of less than 6 mos.
Leg-driven treadmill-based exoskeleton robot training can improve balance function in poststroke patients and is beneficial for patients with an onset of greater than 6 mos. However, there is no evidence to support the efficacy of walking ability.
本研究旨在系统回顾下肢驱动跑步机式外骨骼机器人训练对脑卒中患者平衡和步行能力的影响。
从建库至 2021 年 8 月,检索 PubMed、Cochrane Library、Embase、Web of Science、Medline、中国知网、维普及万方数据库,采用 Cochrane 手册评价文献质量。主要结局指标为功能性步行分类量表和 Berg 平衡量表,次要结局指标为 10 米步行测试、6 分钟步行测试和步态评估步频。
系统评价纳入 17 项随机对照试验,15 项进行了荟萃分析。主要结局指标中,功能性步行分类量表评分无显著差异;亚组中,外骨骼机器人+常规疗法的 Berg 平衡量表评分显著增加;次要结局指标中,6 分钟步行测试或 10 米步行测试无显著意义。治疗组发病时间超过 6 个月的亚组步频增加,对照组优于发病时间小于 6 个月的亚组。
下肢驱动跑步机式外骨骼机器人训练可改善脑卒中患者的平衡功能,对发病时间超过 6 个月的患者有益。然而,目前尚无证据支持其对步行能力的疗效。