机器人辅助步态训练器 Walkbot 联合物理疗法与单纯物理疗法治疗脑性瘫痪患儿和青少年的疗效比较。实验研究。

Treatment with robot-assisted gait trainer Walkbot along with physiotherapy vs. isolated physiotherapy in children and adolescents with cerebral palsy. Experimental study.

机构信息

International Doctoral School of the University of Murcia (EIDUM), University of Murcia, Murcia, 30100, Spain.

Faculty of Physiotherapy, Occupational Therapy and Podiatry, UCAM Catholic University of Murcia, Guadalupe, Murcia, 30107, Spain.

出版信息

BMC Neurol. 2024 Jul 15;24(1):245. doi: 10.1186/s12883-024-03750-9.

DOI:10.1186/s12883-024-03750-9

PMID:39009990

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11247728/

Abstract

BACKGROUND

Improving walking ability is a key objective in the treatment of children and adolescents with cerebral palsy, since it directly affects their activity and participation. In recent years, robotic technology has been implemented in gait treatment, which allows training of longer duration and repetition of the movement. To know the effectiveness of a treatment with the robotic-assisted gait trainer Walkbot combined with physiotherapy compared to the isolated physiotherapy treatment in children and adolescents with cerebral palsy, we carried out a clinical trial.

METHODS

23 participants, were divided into two groups: experimental and control. During 5 weeks, both groups received their physiotherapy sessions scheduled, in addition experimental group received 4 sessions per week of 40 min of robot. An evaluation of the participants was carried out before the intervention, at the end of the intervention, and at follow-up (two months after the end of the intervention). Gait was assessed with the Gross Motor Function Measure-88 dimensions D and E, strength was measured with a hydraulic dynamometer, and range of motion was assessed using the goniometer. A mixed ANOVA was performed when the assumptions of normality and homoscedasticity were met, and a robust mixed ANOVA was performed when these assumptions were not met. Statistical significance was stipulated at p < 0.05. For the effect size, η was calculated.

RESULTS

Significant differences were found regarding the time x group interaction in the Gross Motor Function Measure-88 in dimension D [η = 0.016], in the flexion strength of the left [η = 0.128] and right [η = 0.142] hips, in the extension strength of the right hip [η = 0.035], in the abduction strength of the left hip [η = 0.179] and right [η = 0.196], in the flexion strength of the left knee [η = 0.222] and right [η = 0.147], and in the range of motion of left [η = 0.071] and right [η = 0.053] knee flexion.

CONCLUSIONS

Compared to treatments without walking robot, physiotherapy treatment including Walkbot improves standing, muscle strength, and knee range of motion in children and adolescents with cerebral palsy.

TRIAL REGISTRATION

ClinicalTrials.gov: NCT04329793. First posted: April 1, 2020.

摘要

背景

提高行走能力是脑瘫儿童和青少年治疗的关键目标，因为这直接影响他们的活动和参与能力。近年来，机器人技术已应用于步态治疗，从而可以进行更长时间的训练和重复运动。为了了解机器人辅助步态训练器 Walkbot 与单独进行物理治疗相比，在脑瘫儿童和青少年中的治疗效果，我们进行了一项临床试验。

方法

23 名参与者被分为两组：实验组和对照组。在 5 周的时间里，两组都接受了预定的物理治疗课程，此外实验组每周还接受 4 次 40 分钟的机器人治疗。在干预前、干预结束时和随访（干预结束两个月后）对参与者进行了评估。使用粗大运动功能测量-88 维度 D 和 E 评估步态，使用液压测力计测量力量，使用量角器评估运动范围。当满足正态性和同方差性假设时，进行混合方差分析，当不满足这些假设时，进行稳健混合方差分析。规定统计显著性水平为 p<0.05。对于效应大小，计算了η。

结果

在粗大运动功能测量-88 维度 D 的时间 x 组交互作用方面发现了显著差异[η=0.016]，在左[η=0.128]和右[η=0.142]髋关节的屈曲力量、右髋关节的伸展力量[η=0.035]、左髋关节的外展力量[η=0.179]和右髋关节的外展力量[η=0.196]、左膝的屈曲力量[η=0.222]和右膝的屈曲力量[η=0.147]以及左膝和右膝的运动范围[η=0.071]和右膝的运动范围[η=0.053]。