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住院环境下成人脑瘫患者机器人辅助步态训练的安全性与可行性——一项观察性研究

Safety and Feasibility of Robot-assisted Gait Training in Adults with Cerebral Palsy in an Inpatient Setting - an Observational Study.

作者信息

Moll Fabian, Kessel Axel, Bonetto Anna, Stresow Johanna, Herten Monika, Dudda Marcel, Adermann Jens

机构信息

Klinik für Manuelle Therapie Hamm (Hospital for Pain Management), Ostenalle 83, 59071 Hamm, Germany.

Department for Trauma-, Hand- and Reconstructive Surgery, University Hospital Essen, University of Duisburg-Essen, Hufelandstraße 55, 45147 Essen, Germany.

出版信息

J Dev Phys Disabil. 2023 Feb 11:1-16. doi: 10.1007/s10882-023-09895-8.

Abstract

BACKGROUND

To investigate the safety and feasibility of six sessions of Hybrid Assistive Limb (HAL) robot-assisted gait training (RAGT) integrated into an inpatient therapy concept and their influence on walking speed and gait parameters in adult CP patients.

METHODS

Eleven subjects (male = 8, female = 3, mean age: 23 years and 2 months, ± 4.5 years) with spastic CP underwent six 20-minute RAGT sessions with the HAL during an 11-day hospital stay. Additionally, physiotherapy, physician-performed manual medicine, massage and exercise therapy were provided. Pre- (T1) and post- (T2) intervention assessments were: 10-metre walking test (10MWT), 6-minute walking test (6MWT), Gross Motor Function Measure (GMFM-88) and lower extremities passive range of motion (pROM).

RESULTS

All subjects completed the study. No adverse events were noted. Walking speed in the 10MWT test increased from 32.5 s (± 24.5 s) at T1 to 27.5 s (± 21.4 s) at T2, without significance. Slight, but non-significant improvements were detected in the 6MWT, GMFM and pROM. Confounding factors did not significantly affect the results. Conclusion: Intensive therapy including HAL training leads to non-significant improvements. Further studies with more patients and longer intervention time could provide further insights into the RAGT therapy of adult patients with CP. Registration DRKS-ID: DRKS00020275.

摘要

背景

探讨将六次混合辅助肢体(HAL)机器人辅助步态训练(RAGT)纳入住院治疗方案的安全性和可行性,以及其对成年脑瘫(CP)患者步行速度和步态参数的影响。

方法

11例痉挛型CP患者(男性8例,女性3例,平均年龄23岁2个月,±4.5岁)在11天的住院期间,使用HAL进行了六次每次20分钟的RAGT训练。此外,还提供了物理治疗、医生实施的手法治疗、按摩和运动疗法。干预前(T1)和干预后(T2)的评估包括:10米步行测试(10MWT)、6分钟步行测试(6MWT)、粗大运动功能测量(GMFM-88)和下肢被动活动范围(pROM)。

结果

所有受试者均完成了研究。未观察到不良事件。10MWT测试中的步行速度从T1时的32.5秒(±24.5秒)增加到T2时的27.5秒(±21.4秒),但无统计学意义。6MWT、GMFM和pROM有轻微但无统计学意义的改善。混杂因素对结果无显著影响。结论:包括HAL训练在内的强化治疗导致的改善无统计学意义。对更多患者进行更长时间干预的进一步研究,可能会为成年CP患者的RAGT治疗提供更多见解。注册DRKS-ID:DRKS00020275。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ab9/9918396/3c734621eaaa/10882_2023_9895_Fig1_HTML.jpg

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