Wernig A, Nanassy A, Müller S
Department of Physiology, University of Bonn, Germany.
Spinal Cord. 1998 Nov;36(11):744-9. doi: 10.1038/sj.sc.3100670.
Recent reports indicate that walking capabilities in spinal cord damaged persons significantly improve--as compared to conventional rehabilitation therapy--after intensive training of aided (Laufband) treadmill-stepping. In the present report, follow up investigations on two collectives of spinal cord injured (sci) persons are described who had undergone (Laufband) treadmill therapy either during a period of renewed rehabilitation months or years after spinal cord injury (35 chronic patients) or during their first postacute rehabilitation period (41 acute patients). Among the initially chronic patients, 20 from 25 still wheelchair-bound before the onset of (Laufband) treadmill therapy, ie not capable of raising from the wheelchair and walking without help by other persons, became independent walkers after therapy. Assessment of voluntary muscle activity in resting position before and after the period of therapy had shown only small increases in most patients, indicating the involvement of motor automatisms and better utilisation of remaining muscle function during walking. Follow-up assessments performed 6 months to 6 1/2 years after discharge from the hospital revealed that the walking capabilities achieved by (Laufband) treadmill therapy in the 35 initially chronic patients were maintained in 31 persons, in three they had further improved, in only one it was reduced. These results indicate that the improvements achieved under clinical conditions can be maintained in every day life under domestic surroundings. From 41 initially acute patients, 15 had further improved and none had reduced his walking capability 6 months to 6 years after discharge from the hospital.
最近的报告表明，与传统康复治疗相比，脊髓损伤患者在接受强化辅助（跑步机）踏步行走训练后，行走能力显著提高。在本报告中，描述了对两组脊髓损伤（SCI）患者的随访调查，这两组患者分别在脊髓损伤数月或数年（35例慢性病患者）后的再次康复期间或首次急性康复期（41例急性病患者）接受了（跑步机）踏疗。在最初的慢性病患者中，25例在（跑步机）踏疗开始前仍需轮椅辅助，即无法自行从轮椅上起身并独立行走，经过治疗后，其中20例成为了独立行走者。治疗前后静息状态下的自主肌肉活动评估显示，大多数患者仅有小幅增加，这表明行走过程中运动自动性的参与以及对剩余肌肉功能的更好利用。出院后6个月至6年半进行的随访评估显示，35例最初的慢性病患者通过（跑步机）踏疗所获得的行走能力，在31例患者中得以维持，3例有所改善，仅1例有所下降。这些结果表明，在临床条件下取得的改善在家庭日常生活环境中能够得以维持。41例最初的急性病患者中，15例有所改善，出院后6个月至6年，无一例行走能力下降。
