Effectiveness of Acute Phase Hybrid Assistive Limb Rehabilitation in Stroke Patients Classified by Paralysis Severity
Effectiveness of Acute Phase Hybrid Assistive Limb Rehabilitation in Stroke Patients Classified by Paralysis Severity
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DOI：
10.2176/nmc.oa.2014-0431
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发表时间：
2015-06-01
影响因子：
1.9
通讯作者：
Inoue, Tooru
中科院分区：
文献类型：
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作者：
Fukuda, Hiroyuki;Samura, Kazuhiro;Inoue, Tooru
本研究的目的是通过测量瘫痪严重程度的差异来研究急性期混合辅助肢体（HAL）康复训练对中风后患者的有效性。 53 名急性中风患者参加了这项前瞻性队列研究。 HAL 培训大约每周进行两次，平均培训次数为 3.9 +/- 2.7。步行训练在跑步机上进行，跑步机可单独调节体重支撑和速度，并且每次训练前后都有 10 米步行测试 (10MWT)。基线和终点评估包括格拉斯哥昏迷量表 (GCS)、修订的长谷川痴呆量表 (HDS-R)、Brunnstrom 分期 (Brs)、功能独立测量 (FIM)、Barthel 指数 (BI) 和 10MWT。我们在第一次步行训练课程和最后一次没有 HAL 的训练课程结束时测量了这些评估。为了评估使用 HAL 进行训练的可行性，使用不同Brs中的配对Wilcoxon符号秩检验在训练前后比较了BI、FIM以及10MIATT的速度和步数的结果测量。除Brs IV外，Brs III或更高亚组的BI显示出显着改善，Brs III亚组的FIM显示出显着改善。 Brs V 和 VI 亚组在 10 米步行速度和步数方面表现出显着改善。在中风后的急性期康复中，HAL被认为对于下肢麻痹程度较轻的患者（例如Brs III或更高级别）更有效。
The purpose of the present study was to investigate the effectiveness of acute phase hybrid assistive limb (HAL) rehabilitation training for patients after stroke by measuring the difference in the severity of paralysis. Fifty-three acute stroke patients were enrolled in this prospective cohort study. HAL training was administered about twice per week, and the mean number of sessions was 3.9 +/- 2.7. The walking training was performed on a treadmill with individually adjustable body weight support and speed and there was a 10-m walk test (10MWT) before and after each session. Assessment at baseline and at endpoint consisted of the Glasgow Coma Scale (GCS), Revised Hasegawa's Dementia Scale (HDS-R), Brunnstrom stage (Brs), Functional Independence Measure (FIM), Barthel index (BI), and 10MWT. We measured these assessments at the first walking training session and at the end of the final training session without the HAL. To evaluate the feasibility of training with the HAL, the outcome measures of BI, FIM, and speed and number of steps of 10MIATT were compared before and after training using a paired Wilcoxon's signed-rank test in different Brs. Except for Brs IV, the Brs III or higher subgroups displayed significant amelioration in BI, and the Brs III subgroup displayed significant amelioration in FIM. The Brs V and VI subgroups displayed significant amelioration in 10-m walking speed and steps. In acute phase rehabilitation after stroke, it is thought that the HAL is more effective for patients with less lower-limb paralysis, such as Brs III or higher.