Effects of a wearable exoskeleton stride management assist system (SMA®) on spatiotemporal gait characteristics in individuals after stroke: a randomized controlled trial.
Effects of a wearable exoskeleton stride management assist system (SMA®) on spatiotemporal gait characteristics in individuals after stroke: a randomized controlled trial.
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DOI：
10.1186/s12984-015-0062-0
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发表时间：
2015-08-20
影响因子：
5.1
通讯作者：
Jayaraman A
中科院分区：
文献类型：
--
作者：
Buesing C;Fisch G;O'Donnell M;Shahidi I;Thomas L;Mummidisetty CK;Williams KJ;Takahashi H;Rymer WZ;Jayaraman A
机器人提供了一种替代的，潜在的有利方法，提供重复的，高剂量的，高强度的训练，以解决中风引起的步态障碍。在这项研究中，我们比较了步幅管理辅助（SMA®）系统，一个新的可穿戴机器人设备开发的本田R&D公司，日本，功能性任务特定训练（FTST）的时空步态参数中风幸存者。进行了一项单盲随机对照试验，以评估FTST和使用SMA®器械的任务特定步行训练对时空步态参数的影响。受试者（n = 50）被随机分配至FTST或SMA组。两组受试者每周接受3次训练，持续6-8周，最多18次训练。使用GAITRite®系统收集受试者在训练前（基线）、训练中期、训练后和3个月随访时的时空步态特征数据。训练后，与基线相比，在两个训练组中观察到步态参数的显着改善，包括速度和节奏的增加，受损侧摆动时间的减少，双支撑时间的减少，受损侧和非受损侧步长的增加，以及受损侧和非受损侧步长的增加。训练组间差异无统计学意义;除SMA组外，在自选步行速度试验中，受损侧步长显著增加，在快速步行试验中，空间不对称性显著降低。SMA和FTST干预在时空步态参数方面提供了相似的显著改善;然而，SMA组在不同时间点的更多参数方面显示出额外的改善。这些结果表明，SMA®器械可能是一种有用的治疗工具，可改善时空参数，并有助于改善卒中幸存者的功能活动性。需要进一步研究来确定在家庭环境与诊所环境中使用该器械的可行性，以及这种家庭使用是否提供持续的益处。本研究以标题“开发行走辅助装置以改善社区步行”注册，可登录clinicaltrials.gov，研究标识符为：NCT 01994395。
Robots offer an alternative, potentially advantageous method of providing repetitive, high-dosage, and high-intensity training to address the gait impairments caused by stroke. In this study, we compared the effects of the Stride Management Assist (SMA®) System, a new wearable robotic device developed by Honda R&D Corporation, Japan, with functional task specific training (FTST) on spatiotemporal gait parameters in stroke survivors. A single blinded randomized control trial was performed to assess the effect of FTST and task-specific walking training with the SMA® device on spatiotemporal gait parameters. Participants (n = 50) were randomly assigned to FTST or SMA. Subjects in both groups received training 3 times per week for 6–8 weeks for a maximum of 18 training sessions. The GAITRite® system was used to collect data on subjects’ spatiotemporal gait characteristics before training (baseline), at mid-training, post-training, and at a 3-month follow-up. After training, significant improvements in gait parameters were observed in both training groups compared to baseline, including an increase in velocity and cadence, a decrease in swing time on the impaired side, a decrease in double support time, an increase in stride length on impaired and non-impaired sides, and an increase in step length on impaired and non-impaired sides. No significant differences were observed between training groups; except for SMA group, step length on the impaired side increased significantly during self-selected walking speed trials and spatial asymmetry decreased significantly during fast-velocity walking trials. SMA and FTST interventions provided similar, significant improvements in spatiotemporal gait parameters; however, the SMA group showed additional improvements across more parameters at various time points. These results indicate that the SMA® device could be a useful therapeutic tool to improve spatiotemporal parameters and contribute to improved functional mobility in stroke survivors. Further research is needed to determine the feasibility of using this device in a home setting vs a clinic setting, and whether such home use provides continued benefits. This study is registered under the title “Development of walk assist device to improve community ambulation” and can be located in clinicaltrials.gov with the study identifier: NCT01994395.