Bonanno Mirjam, De Pasquale Paolo, De Marchis Cristiano, Lombardo Facciale Antonino, Paladina Giuseppe, Fonti Bartolo, Quartarone Angelo, Calabrò Rocco Salvatore
IRCCS Centro Neurolesi Bonino-Pulejo, Messina, Italy.
Department of Engineering, University of Messina, Messina, Italy.
Front Bioeng Biotechnol. 2024 Jun 24;12:1385280. doi: 10.3389/fbioe.2024.1385280. eCollection 2024.
Ataxia is a neurological symptom that causes decreased balance, loss of coordination, and gait alterations. Innovative rehabilitation devices like virtual reality (VR) systems can provide task-oriented, repetitive and intensive training with multisensorial feedback, thus promoting neuroplastic processes. Among these VR technologies, the Computer Assisted Rehabilitation ENvironment (CAREN) associates a split belt treadmill on a 6-degrees of freedom platform with a 180° VR screen and a Vicon motion capture system to monitor patients' movements during training sessions. Eight patients affected by cerebellar ataxia were enrolled and received 20 sessions of CAREN training in addition to standard rehabilitation treatment. Each patient was evaluated at the beginning and at the end of the study with 3D gait analysis and clinical scales to assess balance, gait function and risk of falls. We found improvements in kinematic, kinetic, and electromyographic parameters (as per pre-post- CAREN training), as well as in clinical outcomes, such as balance and risk of falls in ataxic patients. In addition, we found that trunk rotation improved, after CAREN intervention, approximating to the normative values. Our results suggested that CAREN might be useful to improve specific biomechanical parameters of gait in ataxic patients.
共济失调是一种神经症状，会导致平衡能力下降、协调能力丧失和步态改变。像虚拟现实（VR）系统这样的创新康复设备可以提供面向任务的、重复性的强化训练，并带有多感官反馈，从而促进神经可塑性过程。在这些VR技术中，计算机辅助康复环境（CAREN）将一个6自由度平台上的分体式跑步机与一个180°VR屏幕以及一个Vicon运动捕捉系统相结合，以在训练过程中监测患者的动作。招募了8名患有小脑共济失调的患者，除了接受标准康复治疗外，还接受了20次CAREN训练。在研究开始和结束时，对每位患者进行了三维步态分析和临床量表评估，以评估平衡能力、步态功能和跌倒风险。我们发现，（与CAREN训练前后相比）患者的运动学、动力学和肌电图参数有所改善，临床结果也有所改善，如共济失调患者的平衡能力和跌倒风险。此外，我们发现，经过CAREN干预后，躯干旋转得到改善，接近正常值。我们的结果表明，CAREN可能有助于改善共济失调患者步态的特定生物力学参数。
