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地面式动力外骨骼在亚急性脑卒中患者步态训练中的临床疗效:一项随机对照初步试验。

Clinical efficacy of overground powered exoskeleton for gait training in patients with subacute stroke: A randomized controlled pilot trial.

机构信息

Department of Physical Medicine and Rehabilitation, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea.

Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

出版信息

Medicine (Baltimore). 2023 Jan 27;102(4):e32761. doi: 10.1097/MD.0000000000032761.

Abstract

BACKGROUND

To investigate the efficacy and usefulness of 12 sessions of overground robot-assisted gait training (RAGT) in subacute stroke patients.

METHODS

In this pilot study, 17 subacute stroke survivors were randomly assigned to the intervention (n = 9) and control (n = 8) groups. In addition to the conventional stroke neurorehabilitation program, the intervention group received 30 minutes of overground exoskeletal RAGT, while the control group received 30 minutes of conventional gait training by a physiotherapist. All interventions were performed in 12 sessions (3 times/week for 4 weeks). The primary aim was to assess ambulation ability using the functional ambulation category (FAC). The 10-m walk test, Berg Balance Scale, timed-up-and-go Timed-up-and-go, Fugl-Meyer assessment of lower extremity, pulmonary function test, the Korean version of the modified Barthel index, and Euro quality of life-5 dimensions (EQ-5D) were assessed. All outcomes were evaluated both before and after the intervention.

RESULTS

The Berg Balance Scale, Korean version of the modified Barthel index, and EQ-5D scores (P < .05) improved significantly in both groups. Only those in the RAGT group improved significantly in the FAC, timed-up-and-go, and 10-m walk test (P < .05). In the FAC and EQ-5D, the intervention group showed greater improvement than the control group (P < .05).

CONCLUSION

We found that 4 weeks of overground RAGT combined with conventional training may improve walking independence and quality of life in patients with subacute stroke.

摘要

背景

研究 12 次地面机器人辅助步态训练(RAGT)对亚急性脑卒中患者的疗效和实用性。

方法

在这项初步研究中,17 名亚急性脑卒中幸存者被随机分配到干预组(n = 9)和对照组(n = 8)。除了常规的脑卒中神经康复方案外,干预组还接受了 30 分钟的地面外骨骼 RAGT,而对照组则由物理治疗师进行 30 分钟的常规步态训练。所有干预均在 12 次(每周 3 次,持续 4 周)内完成。主要目的是使用功能性步行分类(FAC)评估步行能力。10 米步行测试、伯格平衡量表、计时起立行走测试、下肢 Fugl-Meyer 评估、肺功能测试、改良 Barthel 指数的韩国版和欧洲生活质量 5 维度(EQ-5D)均进行了评估。所有结果均在干预前后进行评估。

结果

两组的伯格平衡量表、改良 Barthel 指数韩国版和 EQ-5D 评分(P <.05)均显著改善。只有 RAGT 组的 FAC、计时起立行走测试和 10 米步行测试显著改善(P <.05)。在 FAC 和 EQ-5D 中,干预组的改善程度大于对照组(P <.05)。

结论

我们发现,4 周的地面 RAGT 结合常规训练可能会提高亚急性脑卒中患者的独立行走能力和生活质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2d41/9875981/5995c671f37a/medi-102-e32761-g001.jpg

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