Faulkner James, Wright Amy, Stone Keeron, Fryer Simon, Martinelli Louis, Lambrick Danielle, Paine Eloise, Stoner Lee
Department of Sport, Exercise and Health, University of Winchester, Winchester, United Kingdom.
School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, United Kingdom.
Front Neurol. 2023 Mar 10;14:1093008. doi: 10.3389/fneur.2023.1093008. eCollection 2023.
Overground robotic-assisted gait training (O-RAGT) has been shown to improve clinical functional outcomes in people living with stroke. The purpose of this study was to identify whether a home-based O-RAGT program, in combination with usual care physiotherapy, would demonstrate improvements in vascular health in individuals with chronic stroke, and, whether any changes in vascular outcomes would be sustained 3 months after completing the program. Thirty-four participants with chronic stroke (between 3 months and 5 years post-stroke) were randomized to either a 10-week O-RAGT program in combination with usual care physiotherapy, or to a usual care physiotherapy only control group. Participants' ( = 31) pulse wave analysis (PWA), and regional [carotid-femoral pulse wave analysis (cfPWV)] and local (carotid) measures of arterial stiffness were assessed at baseline, post-intervention, and 3-month post-intervention. Analysis of covariance demonstrated a significant reduction (improvement) in cfPWV between BL and PI for O-RAGT (8.81 ± 2.51 vs. 7.92 ± 2.17 m/s, respectively), whilst the control group remained unchanged (9.87 ± 2.46 vs. 9.84 ± 1.76 m/s, respectively; < 0.05; ηp = 0.14). The improvement in cfPWV was maintained 3 months after completing the O-RAGT program. There were no significant Condition by Time interactions for all PWA and carotid arterial stiffness measures ( > 0.05). A significant increase in physical activity, as determined by the time spent stepping, was observed for O-RAGT between baseline and post-intervention assessments (3.2 ± 3.0-5.2 ± 3.3%, respectively) but not for CON ( < 0.05). The improvement in cfPWV, in combination with an increase in physical activity whilst wearing the O-RAGT and concomitant reduction in sedentary behavior, are important positive findings when considering the application of this technology for "at home" rehabilitation therapy for stroke survivors. Further research is needed to determine whether implementing "at home" O-RAGT programs should be a part of the stroke treatment pathway.
https://clinicaltrials.gov, identifier NCT03104127.
地面机器人辅助步态训练（O-RAGT）已被证明可改善中风患者的临床功能结局。本研究的目的是确定基于家庭的O-RAGT计划与常规护理物理治疗相结合，是否能改善慢性中风患者的血管健康，以及在完成该计划3个月后血管结局的任何变化是否会持续存在。34名慢性中风患者（中风后3个月至5年）被随机分为两组，一组接受为期10周的O-RAGT计划并结合常规护理物理治疗，另一组仅接受常规护理物理治疗作为对照组。在基线、干预后和干预后3个月评估参与者（n = 31）的脉搏波分析（PWA）以及区域[颈动脉-股动脉脉搏波分析（cfPWV）]和局部（颈动脉）动脉僵硬度测量值。协方差分析表明，O-RAGT组在基线和干预后之间cfPWV有显著降低（改善）（分别为8.81±2.51 vs. 7.92±2.17 m/s），而对照组保持不变（分别为9.87±2.46 vs. 9.84±1.76 m/s；P < 0.05；ηp = 0.14）。在完成O-RAGT计划3个月后，cfPWV的改善得以维持。所有PWA和颈动脉僵硬度测量值均未观察到显著的条件×时间交互作用（P > 0.05）。在基线和干预后评估之间，观察到O-RAGT组的身体活动显著增加，以步数时间衡量（分别为3.2±3.0 - 5.2±3.3%），而对照组则没有（P < 0.05）。考虑将该技术应用于中风幸存者的“居家”康复治疗时，cfPWV的改善、佩戴O-RAGT时身体活动的增加以及久坐行为的相应减少都是重要的积极发现。需要进一步研究以确定实施“居家”O-RAGT计划是否应成为中风治疗途径的一部分。
