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Lokomat与传统疗法——对偏瘫患者步态对称性的影响:初步临床研究

Lokomat vs. Conventional Therapy-Impact on Gait Symmetry in Hemiparetic Patients: Preliminary Clinical Study.

作者信息

Potašová Marina, Mačej Peter, Moraučíková Eva, Baňárová Patrícia Shtin, Kutiš Peter

机构信息

Faculty of Health, Catholic University of Ružomberok, 034 01 Ružomberok, Slovakia.

Rehabilitation Institute in Hrabyně, 747 67 Hrabyně, Czech Republic.

出版信息

Healthcare (Basel). 2025 Apr 18;13(8):929. doi: 10.3390/healthcare13080929.

Abstract

: One of the primary goals of neurorehabilitation after stroke is gait reeducation, as it provides the patient with greater autonomy and enhances their safety in daily activities. A preliminary clinical study was undertaken to determine whether robotic gait reeducation using the Lokomat device is more effective than conventional therapy in achieving gait symmetry. : The research group consisted of 107 patients, with an average age of 63.54 years, all in the subacute stage of hemiparesis. These patients underwent 4 weeks of neurorehabilitation and were assigned into experimental and control groups. The patients in the experimental group underwent neurorehabilitation (20 sessions) and twice-weekly walking on the Lokomat device (10 sessions). The control group received equivalent neurorehabilitation and conventional gait reeducation. We monitored the return of ideal limb loading (to a 50:50 ratio) and the restoration of the step length on the paretic limb to a physiological length (73 cm), as well as the subsequent restoration of gait symmetry. The measurements were performed using the HP Cosmos Zebris Treadmill FDM-T device. The Wilcoxon Signed Rank test was conducted within each group to analyze the effectiveness of gait reeducation before and after therapy. To compare the results between the two groups, the Mann-Whitney test (α = 0.05) was employed. : There was no significant difference between the robotic and conventional therapy groups ( = 0.432 (>0.05)). A significant change occurred only in the control group in the 50:50 limb loading parameter ( = 0.042). There were no significant changes in the other parameters. : Under the conditions of our study, robot-guided gait reeducation did not appear to be more effective than conventional therapy. The monthly duration of gait reeducation is insufficient to achieve a symmetrical gait in patients with spastic hemiparesis.

摘要

中风后神经康复的主要目标之一是步态再训练,因为它能让患者获得更大的自主性,并提高他们在日常活动中的安全性。进行了一项初步临床研究,以确定使用Lokomat设备进行机器人辅助步态再训练在实现步态对称性方面是否比传统疗法更有效。研究组由107名患者组成,平均年龄为63.54岁,均处于偏瘫亚急性期。这些患者接受了4周的神经康复治疗,并被分为实验组和对照组。实验组患者接受神经康复治疗(20次疗程),并每周两次在Lokomat设备上行走(10次疗程)。对照组接受同等的神经康复治疗和传统步态再训练。我们监测了理想肢体负重的恢复情况(达到50:50的比例)以及患侧肢体步长恢复到生理长度(73厘米)的情况,以及随后步态对称性的恢复。测量使用HP Cosmos Zebris Treadmill FDM-T设备进行。在每组内进行Wilcoxon符号秩检验,以分析治疗前后步态再训练的有效性。为了比较两组结果,采用了Mann-Whitney检验(α = 0.05)。机器人辅助治疗组和传统治疗组之间没有显著差异( = 0.432(>0.05))。仅在对照组中,50:50肢体负重参数出现了显著变化( = 0.042)。其他参数没有显著变化。在我们的研究条件下,机器人引导的步态再训练似乎并不比传统疗法更有效。每月的步态再训练时长不足以使痉挛性偏瘫患者实现对称步态。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/20a5/12027008/a78f83153338/healthcare-13-00929-g001.jpg

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