Abnormal synergistic gait mitigation in acute stroke using an innovative ankle-knee-hip interlimb humanoid robot: a preliminary randomized controlled trial.
Abnormal synergistic gait mitigation in acute stroke using an innovative ankle-knee-hip interlimb humanoid robot: a preliminary randomized controlled trial.
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DOI：
10.1038/s41598-021-01959-z
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发表时间：
2021-11-24
影响因子：
4.6
通讯作者：
You JSH
中科院分区：
文献类型：
--
作者：
Park C;Oh-Park M;Bialek A;Friel K;Edwards D;You JSH
异常痉挛和相关的协同模式是影响偏瘫卒中患者踝-膝-髋肢体间协调步态运动学和动力学的最常见神经肌肉损伤。尽管偏瘫中风患者接受各种治疗来改善步态和运动，但机器人辅助和常规治疗后痉挛和相关协同模式如何变化仍不清楚。我们开发了一种创新的踝-膝-髋肢间协调人形机器人（ICT），以减轻异常痉挛和协同模式。初步临床试验的目的是比较ICT联合常规物理治疗（ICT-C）和常规物理治疗和步态训练（CPT-G）对20名急性偏瘫患者异常痉挛和协同步态模式的效果。我们进行了二次分析，旨在阐明 ICT-C 组中 ICT 前后，Walkbot ICT 对运动学（时空参数和角度）和动力学（主动力、阻力和刚度）步态参数的生物力学影响。该组的干预措施包括 60 分钟的常规物理治疗加上 30 分钟的机器人辅助训练，每周 7 天，持续 2 周。对膝关节运动学有显着的生物力学影响；髋部、膝部和踝部主动力；髋部、膝部和踝部的阻力；髋部、膝部和踝部僵硬与 ICT-C 相关。我们的新发现为传统疗法辅以机器人辅助疗法治疗中风后急性恢复期患者的异常痉挛、协同和生物力学步态障碍提供了有希望的证据。试验注册：Clinical Trials.gov 标识符 NCT03554642 (14/01/2020)。
Abnormal spasticity and associated synergistic patterns are the most common neuromuscular impairments affecting ankle–knee–hip interlimb coordinated gait kinematics and kinetics in patients with hemiparetic stroke. Although patients with hemiparetic stroke undergo various treatments to improve gait and movement, it remains unknown how spasticity and associated synergistic patterns change after robot-assisted and conventional treatment. We developed an innovative ankle–knee–hip interlimb coordinated humanoid robot (ICT) to mitigate abnormal spasticity and synergistic patterns. The objective of the preliminary clinical trial was to compare the effects of ICT combined with conventional physical therapy (ICT-C) and conventional physical therapy and gait training (CPT-G) on abnormal spasticity and synergistic gait patterns in 20 patients with acute hemiparesis. We performed secondary analyses aimed at elucidating the biomechanical effects of Walkbot ICT on kinematic (spatiotemporal parameters and angles) and kinetic (active force, resistive force, and stiffness) gait parameters before and after ICT in the ICT-C group. The intervention for this group comprised 60-min conventional physical therapy plus 30-min robot-assisted training, 7 days/week, for 2 weeks. Significant biomechanical effects in knee joint kinematics; hip, knee, and ankle active forces; hip, knee, and ankle resistive forces; and hip, knee, and ankle stiffness were associated with ICT-C. Our novel findings provide promising evidence for conventional therapy supplemented by robot-assisted therapy for abnormal spasticity, synergistic, and altered biomechanical gait impairments in patients in the acute post-stroke recovery phase. Trial Registration: Clinical Trials.gov identifier NCT03554642 (14/01/2020).
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影响因子：
2.7
作者：
Goffredo, Michela;Iacovelli, Chiara;Franceschini, Marco
通讯作者：
Franceschini, Marco
影响因子：
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通讯作者：
Pons, Jose L.
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