Effectiveness of automated locomotor training in patients with chronic incomplete spinal cord injury: A multicenter trial
Effectiveness of automated locomotor training in patients with chronic incomplete spinal cord injury: A multicenter trial
复制标题
DOI：
10.1016/j.apmr.2004.08.004
复制
发表时间：
2005-04-01
影响因子：
4.3
通讯作者：
Hornby, TG
中科院分区：
文献类型：
--
作者：
Wirz, M;Zemon, DH;Hornby, TG
目的：确定使用驱动步态矫形器（DGO）进行自动运动训练是否可以增加慢性运动不完全性脊髓损伤（SCI）患者的功能活动性。设计：对相同患者进行重复评估或单一病例实验A-B设计。设置：芝加哥、德国海德堡、瑞士巴塞尔和苏黎世康复医院的研究单位。参与者：20例慢性（伤后> 2年）运动不完全性SCI患者，根据美国脊髓损伤协会（ASIA）损伤量表分类为ASIA C级（n = 9）和D级（n = 11）损伤。大多数患者（n = 16）在运动训练前都能走动。干预：运动训练使用机器人辅助，体重支持的跑步机训练，每周3至5次，持续8周。单次训练持续长达45分钟的总步行时间，步态速度在0.42和0.69 m/s之间，体重卸载尽可能低（平均值+/-标准差，37% +/- 17%）。主要结果测量包括10米步行试验、6分钟步行试验、定时起身和行走试验，和脊髓损伤行走指数II测试。次要指标包括下肢运动评分和痉挛性运动行为，以评估其对运动功能变化的潜在贡献。所有受试者进行测试之前，期间和之后的training.Results：使用DGO的运动训练导致显着改善受试者的步态速度，耐力，和功能任务的性能。对助行器、矫形器或外部物理辅助的需求没有显著变化。步行速度的改善或肌肉力量或痉挛运动behaviors.Conclusions的变化之间没有相关性：在跑步机上密集的运动训练的协助下，DGO结果改善地上行走。
Objective: To determine whether automated locomotor training with a driven-gait orthosis (DGO) can increase functional mobility in people with chronic, motor incomplete spinal cord injury (SCI).Design: Repeated assessment of the same patients or single-case experimental A-B design.Setting: Research units of rehabilitation hospitals in Chicago; Heidelberg, Germany; and Basel and Zurich, Switzerland.Participants: Twenty patients with a chronic (> 2y postinjury), motor incomplete SCI, classified by the American Spinal Injury Association (ASIA) Impairment Scale with ASIA grades C (n = 9) and D (n = 11) injury. Most patients (n = 16) were ambulatory before locomotor training.Intervention: Locomotor training was provided using robotic-assisted, body-weight-supported treadmill training 3 to 5 times a week over 8 weeks. Single training sessions lasted up to 45 minutes of total walking time, with gait speed between .42 and .69m/s and body-weight unloading as low as possible (mean +/- standard deviation, 37% +/- 17%).Main Outcome Measures: Primary outcome measures included the 10-meter walk test, the 6-minute walk test, the Timed Up & Go test, and the Walking Index for Spinal Cord Injury-II tests. Secondary measures included lower-extremity motor scores and spastic motor behaviors to assess their potential contribution to changes in locomotor function. All subjects were tested before, during, and after training.Results: Locomotor training using the DGO resulted in significant improvements in the subjects' gait velocity, endurance, and performance of functional tasks. There were no significant changes in the requirement of walking aids, orthoses, or external physical assistance. There was no correlation between improvements in walking speed or changes in muscle strength or spastic motor behaviors.Conclusions: Intensive locomotor training on a treadmill with the assistance of a DGO results in improved overground walking.