Physiological responses and energy cost of walking on the Gait Trainer with and without body weight support in subacute stroke patients
Physiological responses and energy cost of walking on the Gait Trainer with and without body weight support in subacute stroke patients
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DOI：
10.1186/1743-0003-11-54
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发表时间：
2014-04-10
影响因子：
5.1
通讯作者：
Paolucci, Stefano
中科院分区：
文献类型：
--
作者：
Delussu, Anna Sofia;Morone, Giovanni;Paolucci, Stefano
背景：中风后机器人辅助行走提供了以任务为导向的强化训练。但是，尽管机器人设备日益普及，但有关机电辅助重复步行运动期间心肺和代谢反应的信息却很少。该研究的目的是确定使用带有体重支持 (BWS) 的末端执行器步态训练 (GT) 机是否会影响亚急性中风后偏瘫患者的生理反应和步行能量消耗 (ECW)。 方法：参与者：6 名中风偏瘫患者（患者组：PG）（年龄：66 +/- 15 岁；中风后时间：8 +/- 3 周；4 名男性）和 6 名健康受试者作为对照组（CG：年龄，76 +/- 7 岁；六名男性）。干预措施：地上步行测试 (OWT) 和 GT 辅助步行（0%、30% 和 50% BWS）（GT-BWS0%、30% 和 50%）。主要指标：心率 (HR)、肺通气量、耗氧量、呼吸交换比 (RER) 和 ECW。 结果：干预条件显着影响稳态参数值（HR：p = 0.005，V'E：p = 0.001，V'O-2：p < 0.001），每组的交互条件影响 ECW（p = 0.002）。对于 PG，对能量（V'O-2 和 ECW）要求最高的条件是 OWT 和 GT-BWS0%。相反，对于 CG 来说，要求最低的条件是 OWT。在 GT 中，增加 BWS 会导致两组的能量和心脏需求减少。结论：在 PG 中，GT-BWS 步行导致的心脏代谢需求低于地面步行。这表明对于亚急性中风患者来说，GT-BWS 步行训练可能比地面步行训练更安全。
Background: Robotic-assisted walking after stroke provides intensive task-oriented training. But, despite the growing diffusion of robotic devices little information is available about cardiorespiratory and metabolic responses during electromechanically-assisted repetitive walking exercise. Aim of the study was to determine whether use of an end-effector gait training (GT) machine with body weight support (BWS) would affect physiological responses and energy cost of walking (ECW) in subacute post-stroke hemiplegic patients.Methods: Participants: six patients ( patient group: PG) with hemiplegia due to stroke (age: 66 +/- 15y; time since stroke: 8 +/- 3 weeks; four men) and 6 healthy subjects as control group (CG: age, 76 +/- 7y; six men). Interventions: overground walking test (OWT) and GT-assisted walking with 0%, 30% and 50% BWS (GT-BWS0%, 30% and 50%). Main Outcome Measures: heart rate (HR), pulmonary ventilation, oxygen consumption, respiratory exchange ratio (RER) and ECW.Results: Intervention conditions significantly affected parameter values in steady state (HR: p = 0.005, V'E: p = 0.001, V'O-2: p < 0.001) and the interaction condition per group affected ECW ( p = 0.002). For PG, the most energy (V'O-2 and ECW) demanding conditions were OWT and GT-BWS0%. On the contrary, for CG the least demanding condition was OWT. On the GT, increasing BWS produced a decrease in energy and cardiac demand in both groups.Conclusions: In PG, GT-BWS walking resulted in less cardiometabolic demand than overground walking. This suggests that GT-BWS walking training might be safer than overground walking training in subacute stroke patients.