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体重支持反馈步行器步态训练对不完全性脊髓损伤患者步行器依赖、下肢肌肉激活及步态能力的影响:一项前瞻性随机对照试验。

Effects of gait training with weight support feedback walker on walker dependence, lower limb muscle activation, and gait ability in patients with incomplete spinal cord injury: A pilot randomized controlled trial.

作者信息

Park Chang Sune, Oh Gku Bin, Cho Ki Hun

机构信息

Department of Physical Therapy, Korea National University of Transportation, Jeungpyeong-gun, Republic of Korea.

出版信息

J Spinal Cord Med. 2025 Jan;48(1):103-111. doi: 10.1080/10790268.2023.2260532. Epub 2023 Sep 28.

Abstract

BACKGROUND

Spinal cord injury (SCI) is a devastating condition affecting an individual's life, particularly through lower extremity paralysis, which limits walking and daily activities.

OBJECTIVES

This study investigated the effects of weight support feedback walker (WSFW) gait training on walker dependence, lower limb muscle activation, and gait ability in patients with incomplete SCI (ISCI).

METHODS

Eleven subjects capable of walking > 20 m with and without a walker were randomly assigned to WSFW gait training (n = 6) or conventional walker (CW) gait training groups (n = 5). All subjects underwent standard physical therapy for 4 weeks. Additionally, the WSFW group participated in WSFW gait training, whereas the CW group participated in CW gait training conducted for 30 min per day, thrice per week, for 4 weeks. Walker dependence (the average force pressing WSFW with the user's arm during walker gait), lower extremity muscle activity (rectus femoris, biceps femoris, and medial gastrocnemius), and gait ability (gait elements: velocity, cadence, step length, and step length asymmetry) were measured to investigate the effects of training.

RESULTS

The WSFW group showed significant decrease in walker dependence compared to the CW group ( < 0.05). Some lower extremity muscle activation (left side biceps femoris) and velocity of the gait elements were increased in the WSFW group compared with those in the CW group ( < 0.05).

CONCLUSION

WSFW gait training could help patients with ISCI transfer their body weight to the paralyzed lower extremity. However, a randomized controlled trial with several subjects is essential to verify the effects of WSFW training.

摘要

背景

脊髓损伤(SCI)是一种严重影响个人生活的疾病,尤其是通过下肢瘫痪,这限制了行走和日常活动。

目的

本研究调查了体重支持反馈步行器(WSFW)步态训练对不完全性脊髓损伤(ISCI)患者步行器依赖、下肢肌肉激活和步态能力的影响。

方法

11名能够在使用和不使用步行器的情况下行走超过20米的受试者被随机分配到WSFW步态训练组(n = 6)或传统步行器(CW)步态训练组(n = 5)。所有受试者均接受了4周的标准物理治疗。此外,WSFW组参与了WSFW步态训练,而CW组参与了每天30分钟、每周三次、共4周的CW步态训练。测量步行器依赖(步行器步态期间用户手臂按压WSFW的平均力)、下肢肌肉活动(股直肌、股二头肌和腓肠肌内侧头)和步态能力(步态要素:速度、步频、步长和步长不对称性),以研究训练效果。

结果

与CW组相比,WSFW组的步行器依赖显著降低(<0.05)。与CW组相比,WSFW组的一些下肢肌肉激活(左侧股二头肌)和步态要素速度有所增加(<0.05)。

结论

WSFW步态训练可以帮助ISCI患者将体重转移到瘫痪的下肢。然而,需要进行一项有多个受试者的随机对照试验来验证WSFW训练的效果。

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