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慢性中风患者能从带有末端执行器的机器人步态训练中获益吗?一项病例对照研究。

May Patients with Chronic Stroke Benefit from Robotic Gait Training with an End-Effector? A Case-Control Study.

作者信息

Bonanno Mirjam, De Pasquale Paolo, Lombardo Facciale Antonino, Dauccio Biagio, De Luca Rosaria, Quartarone Angelo, Calabrò Rocco Salvatore

机构信息

IRCCS Centro Neurolesi Bonino-Pulejo, 98124 Messina, Italy.

Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, 98125 Messina, Italy.

出版信息

J Funct Morphol Kinesiol. 2025 May 6;10(2):161. doi: 10.3390/jfmk10020161.

Abstract

: Gait and balance alterations in post-stroke patients are one of the most disabling symptoms that can persist in chronic stages of the disease. In this context, rehabilitation has the fundamental role of promoting functional recovery, mitigating gait and balance deficits, and preventing falling risk. Robotic end-effector devices, like the G-EO system (e.g., G-EO system, Reha Technology, Olten, Switzerland), can be a useful device to promote gait recovery in patients with chronic stroke. Twelve chronic stroke patients were enrolled and evaluated at baseline (T0) and at post-treatment (T1). These patients received forty sessions of robotic gait training (RGT) with the G-EO system (experimental group, EG), for eight weeks consecutively, in addition to standard rehabilitation therapy. The data of these subjects were compared with those coming from a sample of twelve individuals (control group, CG) matched for clinical and demographic features who underwent the same amount of conventional gait training (CGT), in addition to standard rehabilitation therapy. All patients completed the trial, and none reported any side effects either during or following the training. The EG showed significant improvements in balance ( = 0.012) and gait ( = 0.004) functions measured with the Tinetti Scale (TS) after RGT. Both groups (EG and CG) showed significant improvement in functional independence (FIM, < 0.001). The Fugl-Meyer Assessment-Lower Extremity (FMA-LE) showed significant improvements in motor function ( = 0.001, = 0.031) and passive range of motion ( = 0.031) in EG. In EG, gait and balance improvements were influenced by session, age, gender, time since injury (TSI), cadence, and velocity ( < 0.05), while CG showed fewer significant effects, mainly for age, TSI, and session. EG showed significantly greater improvements than CG in balance ( = 0.003) and gait ( = 0.05) based on the TS. RGT with end-effectors, like the G-EO system, can be a valuable complementary treatment in neurorehabilitation, even for chronic stroke patients. Our findings suggest that RGT may improve gait, balance, and lower limb motor functions, enhancing motor control and coordination.

摘要

中风后患者的步态和平衡改变是疾病慢性阶段可能持续存在的最致残症状之一。在这种情况下,康复在促进功能恢复、减轻步态和平衡缺陷以及预防跌倒风险方面具有重要作用。机器人末端执行器设备,如G-EO系统(例如,瑞士奥尔滕的Reha Technology公司的G-EO系统),可能是促进慢性中风患者步态恢复的有用设备。招募了12名慢性中风患者,并在基线(T0)和治疗后(T1)进行评估。这些患者除接受标准康复治疗外,还连续八周接受了40次使用G-EO系统的机器人步态训练(RGT)(实验组,EG)。将这些受试者的数据与来自12名个体样本(对照组,CG)的数据进行比较,这些个体在临床和人口统计学特征上相匹配,除标准康复治疗外,还接受了相同量的传统步态训练(CGT)。所有患者均完成试验,且在训练期间或训练后均未报告任何副作用。实验组在接受RGT后,使用Tinetti量表(TS)测量的平衡(P = 0.012)和步态(P = 0.004)功能有显著改善。两组(EG和CG)在功能独立性(FIM,P < 0.001)方面均有显著改善。Fugl-Meyer下肢评估量表(FMA-LE)显示实验组在运动功能(P = 0.001,P = 0.031)和被动活动范围(P = 0.031)方面有显著改善。在实验组中,步态和平衡的改善受训练次数、年龄、性别、受伤时间(TSI)、步频和速度的影响(P < 0.05),而对照组的显著影响较少,主要是年龄、TSI和训练次数。基于TS,实验组在平衡(P = 0.003)和步态(P = 0.05)方面的改善明显大于对照组。使用如G-EO系统这样的末端执行器进行RGT,即使对于慢性中风患者,也可能是神经康复中有价值的辅助治疗方法。我们的研究结果表明,RGT可能改善步态、平衡和下肢运动功能,增强运动控制和协调能力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/60ab/12101270/378ca8c9fd1b/jfmk-10-00161-g001.jpg

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