Watanabe Hiroki, Mathis Bryan J, Ueno Tomoyuki, Taketomi Masakazu, Kubota Shigeki, Marushima Aiki, Kawamoto Hiroaki, Sankai Yoshiyuki, Matsumura Akira, Hada Yasushi
Department of Neurosurgery, Institute of Medicine, University of Tsukuba, Tsukuba 305-8575, Ibaraki, Japan.
International Medical Center, University of Tsukuba Hospital, Tsukuba 305-8576, Ibaraki, Japan.
J Clin Med. 2023 Aug 19;12(16):5389. doi: 10.3390/jcm12165389.
Stroke rehabilitation with mechanical assistance improves outcomes by facilitating repetition and relieving the care burden of therapy staff. Here, we tested the Medical Care Pit (MCP) walking assistance training device in the rehabilitation of eight acute stroke patients (median age 60.7 ± 16.3 years) who had recently suffered ischemic (three) or hemorrhagic (five) stroke (14.1 ± 6.5 days). Patients received standard rehabilitation approximately 5 days per week (weekdays only), plus MCP therapy twice a week, totaling four MCP sessions over 2 weeks. Fugl-Meyer Assessment-Lower Extremities (FMA-LE), Functional Ambulation Category (FAC), and other gait-associated parameters were measured. Over the 10.5 ± 1.6 days of therapy, MCP qualitatively assisted in gait analysis and real-time patient feedback while independent walking scores significantly improved (FAC 2.2 ± 0.8 to 3.1 ± 1.3, = 0.020). FMA-LE scores also slightly improved but not to significance ( = 0.106). Objective burden on patients, as measured by modified Borg scale, was significantly improved (2.7 ± 1.6 to 2.0 ± 1.6, = 0.014). In terms of questionnaires, anxiety scores for the physical therapist regarding gait training and falling with MCP significantly decreased (3.8 ± 2.3 to 1.0 ± 1.6; = 0.027 and 3.1 ± 2.2 to 0.8 ± 1.3; = 0.045) from the first to fourth sessions. Taken together, MCP, in addition to the usual rehabilitation program, was effective in gait rehabilitation for independent walking and relieved burdens on the patients. Such walking support systems may be an important part of acute stroke rehabilitation.
机械辅助的中风康复通过促进重复训练和减轻治疗人员的护理负担来改善治疗效果。在此，我们对八名急性中风患者（中位年龄60.7±16.3岁）进行了康复治疗测试，这些患者近期发生了缺血性中风（3例）或出血性中风（5例）（发病14.1±6.5天）。患者每周约5天（仅工作日）接受标准康复治疗，外加每周两次MCP治疗，在2周内共进行4次MCP治疗。测量了Fugl-Meyer下肢评估量表（FMA-LE）、功能性步行分类（FAC）以及其他与步态相关的参数。在10.5±1.6天的治疗过程中，MCP在步态分析和实时患者反馈方面提供了定性辅助，同时独立步行评分显著提高（FAC从2.2±0.8提高到3.1±1.3，P = 0.020）。FMA-LE评分也略有提高，但未达到显著水平（P = 0.106）。通过改良Borg量表测量的患者客观负担显著改善（从2.7±1.6降至2.0±1.6，P = 0.014）。在问卷调查方面，物理治疗师对使用MCP进行步态训练和跌倒的焦虑评分从第一次治疗到第四次治疗显著降低（分别从3.8±2.3降至1.0±1.6；P = 0.027和从3.1±2.2降至0.8±1.3；P = 0.045）。综上所述，除了常规康复计划外，MCP在独立步行的步态康复中有效，并减轻了患者的负担。这种步行支持系统可能是急性中风康复的重要组成部分。
