Robotic-Assisted Step Training (Lokomat) Not Superior to Equal Intensity of Over-Ground Rehabilitation in Patients With Multiple Sclerosis
Robotic-Assisted Step Training (Lokomat) Not Superior to Equal Intensity of Over-Ground Rehabilitation in Patients With Multiple Sclerosis
复制标题
对于多发性硬化症患者来说，机器人辅助踏步训练 (Lokomat) 并不优于同等强度的地上康复训练
DOI：
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发表时间：
2012
影响因子：
4.2
通讯作者：
R. Hilfiker
中科院分区：
文献类型：
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作者：
C. Vaney;B. Gattlen;Véronique Lugon;A. Meichtry;R. Hausammann;Denise Foinant;Anne;Cécilia Palaci;R. Hilfiker
背景。机器人辅助步态训练（RAGT）被建议作为改善多发性硬化症（MS）患者步行能力的干预措施。客观的。本研究旨在评估 RAGT (Lokomat) 在生活质量、活动水平和步态方面是否优于地面步行训练。方法。共有 67 名多发性硬化症患者，其扩展残疾状态量表 (EDSS) 为 3.0 至 6.5，除多模式康复治疗外，还被随机分配接受步行或 RAGT 治疗。主要结果是步行速度、活动水平（估计代谢当量、代谢当量 [MET]，使用加速度计）和生活质量（幸福视觉模拟量表 (VAS) 和 EQ-5D 欧洲 VAS。结果。总共 49 名患者完成了干预措施。平均年龄为 56 岁（范围 36-74 岁），平均 EDSS 为 5.8 (3.0-6.5)，以及基线时的首选步行速度康复前，参与者平均每天花费 68 分钟，MET ≥3。置信区间 (CI) 的上限并未排除步行组的临床相关益处（定义为 0.05 m/s 的差异）；CI 的下限确实排除了临床上重要的益处。结论：对于 EDSS 为 3.0 至 6.5 的患者，RAGT 不太可能优于地面步行训练。
Background. Robot-assisted gait training (RAGT) has been suggested as an intervention to improve walking capacity in patients with multiple sclerosis (MS). Objective. This study aimed to evaluate whether RAGT (Lokomat) is superior to over-ground walking training in terms of quality of life, activity level, and gait. Methods. A total of 67 patients with MS with the Expanded Disability Status Scale (EDSS) 3.0 to 6.5 were randomized to walking or RAGT, in addition to multimodal rehabilitation. Primary outcomes were walking speed, activity level (estimated metabolic equivalent, metabolic equivalents [METs], using an accelerometer), and quality of life (Well-Being Visual Analogue Scale (VAS) and EQ-5D European VAS. Results. In all, 49 patients finished the interventions. Mean age was 56 years (range 36-74 years), mean EDSS was 5.8 (3.0-6.5), and the preferred walking speed at baseline was 0.56 m/s (0.06-1.43 m/s). Before rehabilitation, participants spent on average 68 min/d at an MET ≥3. The walking group improved gait speed nonsignificantly more than the RAGT; the upper bound of the confidence interval (CI) did not exclude a clinically relevant benefit (defined as a difference of 0.05 m/s) in favor of the walking group; the lower bound of the CI did exclude a clinically important benefit in favor of the Lokomat. Quality of life improved in both groups, with a nonsignificant between-group difference in favor of the walking group. Both groups had reduced their activity by 8 weeks after the rehabilitation. Conclusion. It is unlikely that RAGT is better than over-ground walking training in patients with an EDSS between 3.0 and 6.5.