ANKLE PASSIVE AND ACTIVE MOVEMENT TRAINING IN CHILDREN WITH ACUTE BRAIN INJURY USING A WEARABLE ROBOT
ANKLE PASSIVE AND ACTIVE MOVEMENT TRAINING IN CHILDREN WITH ACUTE BRAIN INJURY USING A WEARABLE ROBOT
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DOI：
10.2340/16501977-2285
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发表时间：
2018-01-01
影响因子：
3.5
通讯作者：
Zhang, Li-Qun
中科院分区：
文献类型：
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作者：
Chen, Kai;Xiong, Bo;Zhang, Li-Qun
目的：评估可穿戴机器人设备在指导急性脑损伤儿童踝关节运动恢复的等长扭矩产生和被动-主动运动训练中的可行性和有效性。参与者/设置：10名急性脑损伤住院儿童在康复医院接受治疗。设计：每日机器人引导踝关节被动-主动运动治疗15次，包括实时反馈下的等长扭矩生成，拉伸，采用可穿戴式踝关节康复机器人进行主动运动训练和激励游戏。主要措施：每次训练引起的踝关节生物力学改善，包括踝关节运动范围（ROM）、肌肉力量和临床（Fugl-Meyer下肢功能（FMLE），儿科平衡量表（PBS））和生物力学结果：随着训练的进行，生物力学性能指标的改善遵循对数曲线。每次训练增加背屈主动活动范围（AROM）中位数2.73度（标准差（SD）1.14），背屈强度0.87 Nm（SD 0.90），跖屈强度0.60 Nm（SD 1.19）。经过15次训练后，FMLE评分中位数从14.0增加到14.0，（SD 10.11）至23.0（SD 11.4），PBS从33.0（SD 19.99）至50.0（标准差23.13）（p < 0.05），中位背屈和跖屈强度从0.21 Nm（SD 4.45）至4.0 Nm（SD 7.63）和8.33 Nm（SD 10.18）至18.45 Nm（SD 14.41），平均背屈AROM从-10.45度改善（SD 12.01）至11.87度（SD 20.69），中位背屈胎膜早破从20.0度（SD 9.04）至25.0度（SD 8.03）结论：具有实时反馈的等距扭矩生成，拉伸和主动运动训练有助于促进急性脑损伤儿童的神经可塑性和改善运动表现。
Objective: To evaluate the feasibility and effectiveness of a wearable robotic device in guiding isometric torque generation and passive-active movement training for ankle motor recovery in children with acute brain injury.Participants/setting: Ten inpatient children with acute brain injury being treated in a rehabilitation hospital.Design: Daily robot-guided ankle passive-active movement therapy for 15 sessions, including isometric torque generation under real-time feedback, stretching, and active movement training with motivating games using a wearable ankle rehabilitation robot.Main measures: Ankle biomechanical improvements induced by each training session including ankle range of motion (ROM), muscle strength, and clinical (Fugl-Meyer Lower-Extremity (FMLE), Pediatric Balance Scale (PBS)) and biomechanical (ankle ROM and muscle strength) outcomes over 15 training sessions.Results: As training progressed, improvements in biomechanical performance measures followed logarithmic curves. Each training session increased median dorsiflexion active range of motion (AROM) 2.73 degrees (standard deviation (SD) 1.14), dorsiflexion strength 0.87 Nm (SD 0.90), and plantarflexion strength 0.60 Nm (SD 1.19). After 15 training sessions the median FMLE score had increased from 14.0 (SD 10.11) to 23.0 (SD 11.4), PBS had increased from 33.0 (SD 19.99) to 50.0 (SD 23.13) (p < 0.05), median dorsiflexion and plantarflexion strength had improved from 0.21 Nm (SD 4.45) to 4.0 Nm (SD 7.63) and 8.33 Nm (SD 10.18) to 18.45 Nm (SD 14.41), respectively, median dorsiflexion AROM had improved from -10.45 degrees (SD 12.01) to 11.87 degrees (SD 20.69), and median dorsiflexion PROM increased from 20.0 degrees (SD 9.04) to 25.0 degrees (SD 8.03).Conclusion: Isometric torque generation with real-time feedback, stretching and active movement training helped promote neuroplasticity and improve motor performance in children with acute brain injury.