Effect of Robot-Assisted Gait Training in a Large Population of Children With Motor Impairment Due to Cerebral Palsy or Acquired Brain Injury
Effect of Robot-Assisted Gait Training in a Large Population of Children With Motor Impairment Due to Cerebral Palsy or Acquired Brain Injury
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DOI：
10.1016/j.apmr.2019.08.479
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发表时间：
2020-01-01
影响因子：
4.3
通讯作者：
Castelli, Enrico
中科院分区：
文献类型：
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作者：
Beretta, Elena;Storm, Fabio Alexander;Castelli, Enrico
目的：回顾性评估机器人康复对一大群运动障碍儿童的效果；另一个目标是根据粗大运动功能分类系统确定对脑瘫（CP）和获得性脑损伤（ABI）以及不同程度运动障碍儿童的影响。最后，我们检查了受伤时间对儿童功能的影响。设计：进行了一项队列、前测后测回顾性研究。环境：住院护理。参与者：对总共 182 名儿童进行回顾性评估，其中 110 名患有 ABI，72 名患有 CP，粗大运动功能分类系统 (GMFCS) I-IV 级。干预措施：患者接受了机器人辅助步态训练和体能训练的综合治疗。主要结果指标：所有患者在训练前后均使用6分钟步行测试和粗大运动功能测量进行评估。使用具有 3 个固定因素和 1 个随机因素的线性混合模型来评估改善情况。结果：6 分钟步行测试显示整个组以及 ABI 和 CP 均有所改善。粗大运动功能测量显示整个组和 ABI 患者都有改善，但 CP 儿童则没有改善。 GMFCS 分析显示，ABI 亚组内所有类别的所有结果均显着改善，而 CP 儿童中仅 GMFCS III 的改善显着。结论：运动障碍儿童可以从机器人康复和物理治疗的组合中受益。我们的数据表明，整个组都取得了积极的结果，并且 ABI 和 CP 亚组之间存在显着差异，其中 ABI 儿童的结果更好，这似乎与受伤后经过的时间始终相关。 (C) 2019 年美国康复医学会
Objective: To evaluate retrospectively the effect of robotic rehabilitation in a large group of children with motor impairment; an additional goal was to identify the effects in children with cerebral palsy (CP) and acquired brain injury (ABI) and with different levels of motor impairment according to the Gross Motor Function Classification System. Finally, we examined the effect of time elapsed from injury on children's functions.Design: A cohort, pretest-posttest retrospective study was conducted.Setting: Hospitalized care.Participants: A total of 182 children, 110 with ABI and 72 with CP and with Gross Motor Function Classification System (GMFCS) levels I-IV, were evaluated retrospectively.Interventions: Patients underwent a combined treatment of robot-assisted gait training and physical therapy.Main Outcome Measures: All the patients were evaluated before and after the training using the 6-minute walk test and the Gross Motor Function Measure. A linear mixed model with 3 fixed factors and I random factor was used to evaluate improvements.Results: The 6-minute walk test showed improvement in the whole group and in both ABI and CP. The Gross Motor Function Measure showed improvement in the whole group and in the patients with ABI but not in children with CP. The GMFCS analysis showed that all outcomes improved significantly in all classes within the ABI subgroup, whereas improvements were significant only for GMFCS III in children with CP.Conclusions: Children with motor impairment can benefit from a combination of robotic rehabilitation and physical therapy. Our data suggest positive results for the whole group and substantial differences between ABI and CP subgroups, with better results for children with ABI, that seem to be consistently related to time elapsed from injury. (C) 2019 by the American Congress of Rehabilitation Medicine