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使用安全悬吊装置进行步态训练可加速亚急性脑卒中患者达到监督下行走水平:一项随机对照试验。

Gait training with a safety suspension device accelerates the achievement of supervision level walking in subacute stroke: a randomized controlled trial.

机构信息

Department of Rehabilitation, Fujita Health University Nanakuri Memorial Hospital, Tsu, Mie.

Department of Rehabilitation, Fujita Health University Hospital, Toyoake, Aichi.

出版信息

Int J Rehabil Res. 2024 Jun 1;47(2):75-80. doi: 10.1097/MRR.0000000000000625. Epub 2024 Apr 9.

DOI:10.1097/MRR.0000000000000625
PMID:38595089
Abstract

Practicing walking in a safety suspension device allows patients to move freely and without excessive reliance on a therapist, which requires correcting errors and may facilitate motor learning. This opens the possibility that patients with subacute stroke may improve their walking ability more rapidly. Therefore, we tested the hypothesis that overground gait training in a safety suspension device will result in achieving faster supervision-level walking than gait training without the suspension device. Twenty-seven patients with stroke admitted to the rehabilitation ward with functional ambulation categories (FAC) score of 2 at admission were randomly allocated to safety suspension-device group (SS group) or conventional assisted-gait training group (control group). In addition to regular physical therapy, each group underwent additional gait training for 60 min a day, 5 days a week for 4 weeks. We counted the days until reaching a FAC score of 3 and assessed the probability using Cox regression models. The median days required to reach a FAC score of 3 were 7 days for the SS group and 17.5 days for the control group, which was significantly different between the groups ( P  < 0.05). The SS group had a higher probability of reaching a FAC score of 3 after adjusting for age and admission motor impairment (hazard ratio = 3.61, 95% confidence interval = 1.40-9.33, P  < 0.01). The gait training with a safety suspension device accelerates reaching the supervision-level walking during inpatient rehabilitation. We speculate that a safety suspension device facilitated learning by allowing errors to be experienced and correct in a safe environment.

摘要

在安全悬挂装置中练习行走可以让患者自由移动,而无需过度依赖治疗师,这需要纠正错误,并且可能促进运动学习。这为亚急性脑卒中患者提供了更快改善步行能力的可能性。因此,我们检验了这样一个假设,即在安全悬挂装置中进行的地面行走训练将比没有悬挂装置的步态训练更快达到监督级别的行走。将 27 名入院时功能性步行分类(FAC)评分为 2 的脑卒中患者随机分配到安全悬挂装置组(SS 组)或常规辅助步态训练组(对照组)。除了常规物理治疗外,每组还接受额外的步态训练,每天 60 分钟,每周 5 天,持续 4 周。我们计算达到 FAC 评分为 3 的天数,并使用 Cox 回归模型评估概率。达到 FAC 评分为 3 的中位天数为 SS 组 7 天,对照组 17.5 天,两组之间差异有统计学意义(P <0.05)。调整年龄和入院运动障碍后,SS 组达到 FAC 评分为 3 的概率更高(风险比=3.61,95%置信区间=1.40-9.33,P <0.01)。安全悬挂装置辅助的步态训练可加快住院康复期间达到监督级别的行走。我们推测,安全悬挂装置通过允许在安全的环境中体验和纠正错误,促进了学习。

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