Klobucká Stanislava, Klobucký Robert, Valovičová Katarína, Šiarnik Pavol, Kollár Branislav
Rehabilitation Centre Harmony, Bratislava, Slovakia.
Faculty of Medicine, Slovak Medical University, Bratislava, Slovakia.
Cost Eff Resour Alloc. 2023 Sep 11;21(1):60. doi: 10.1186/s12962-023-00475-3.
To date, there have been no published studies evaluating the cost-effectiveness of robot-assisted gait training (RAGT) in adolescent and adult patients with cerebral palsy (CP). The study´s aim was to analyse the cost-effectiveness of RAGT versus conventional kinesiotherapy (CON) from the health care provider's perspective.
We expressed the cost-effectiveness of RAGT in the Lokomat system after analysing the costs and effects of RAGT and conventional therapy through the Incremental Cost-Effectiveness Ratio (ICER) based on a bicentric randomized controlled study, in which we demonstrated that the intensive RAGT regimen is more effective than conventional therapy in terms of improvements in gross motor functions in adolescent and adult patients with bilateral spastic CP.
According to the calculated ICER ratio for Lokomat, an additional improvement per unit of effect (1% in GMFM), compared to conventional therapy, results in an average cost increase of EUR70.38 per patient in a therapeutic block consisting of 20 TUs (Therapeutic Units).
However, from the comprehensive analysis of the results and evaluation of the long-term effects, it follows that RAGT applied in adolescent and adult patients with bilateral spastic CP is not only more effective in terms of evaluation of monitored clinical parameters, but in the long term it is also more cost-effective compared to conventional therapy.
迄今为止，尚无已发表的研究评估机器人辅助步态训练（RAGT）对青少年和成年脑瘫（CP）患者的成本效益。本研究的目的是从医疗服务提供者的角度分析RAGT与传统运动疗法（CON）相比的成本效益。
在一项双中心随机对照研究的基础上，通过增量成本效益比（ICER）分析RAGT和传统疗法的成本与效果后，我们阐述了Lokomat系统中RAGT的成本效益。在该研究中，我们证明了强化RAGT方案在改善双侧痉挛型CP青少年和成年患者的粗大运动功能方面比传统疗法更有效。
根据计算得出的Lokomat的ICER比值，与传统疗法相比，每单位效果（GMFM提高1%）的额外改善导致在由20个治疗单元（TU）组成的治疗模块中，每位患者的平均成本增加70.38欧元。
然而，从结果的综合分析和长期效果评估来看，应用于双侧痉挛型CP青少年和成年患者的RAGT不仅在监测的临床参数评估方面更有效，而且从长期来看，与传统疗法相比成本效益也更高。
