Multicenter Randomized Clinical Trial Evaluating the Effectiveness of the Lokomat in Subacute Stroke
Multicenter Randomized Clinical Trial Evaluating the Effectiveness of the Lokomat in Subacute Stroke
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DOI：
10.1177/1545968308326632
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发表时间：
2009-01-01
影响因子：
4.2
通讯作者：
Hornby, T. George
中科院分区：
文献类型：
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作者：
Hidler, Joseph;Nichols, Diane;Hornby, T. George
Objective.比较使用Lokomat机器人辅助步态训练与传统步态训练在亚急性卒中患者中的疗效。方法.共有63名中风后< 6个月的参与者完成了多中心随机临床试验，他们的初始步行速度在0.1至0.6 m/s之间。所有参与者都接受了24个1小时的Lokomat或传统步态训练。在训练前、12和24次训练后以及3个月的随访检查时对结果进行评估。自选地上步行速度和6分钟步行距离是主要结果指标，而次要结果指标包括平衡、移动性和功能、节奏和对称性、残疾程度和生活质量指标。结果接受传统步态训练的参与者在步行速度（P = 0.002）和距离（P = 0.03）方面比接受Lokomat训练的参与者有更大的增益。这些差异在3个月随访评价时保持不变。次要指标在两组之间没有差异，尽管观察到传统组与Lokomat组相比节奏改善2倍。结论.对于中度至重度步态障碍的亚急性卒中参与者，传统步态训练干预的多样性似乎比机器人辅助步态训练更有效，有助于恢复步行能力。
Objective. To compare the efficacy of robotic-assisted gait training with the Lokomat to conventional gait training in individuals with subacute stroke. Methods. A total of 63 participants < 6 months poststroke with an initial walking speed between 0.1 to 0.6 m/s completed the multicenter, randomized clinical trial. All participants received twenty-four 1-hour sessions of either Lokomat or conventional gait training. Outcome measures were evaluated prior to training, after 12 and 24 sessions, and at a 3-month follow-up exam. Self-selected overground walking speed and distance walked in 6 minutes were the primary outcome measures, whereas secondary outcome measures included balance, mobility and function, cadence and symmetry, level of disability, and quality of life measures. Results. Participants who received conventional gait training experienced significantly greater gains in walking speed (P = .002) and distance (P = .03) than those trained on the Lokomat. These differences were maintained at the 3-month follow-up evaluation. Secondary measures were not different between the 2 groups, although a 2-fold greater improvement in cadence was observed in the conventional versus Lokomat group. Conclusions. For subacute stroke participants with moderate to severe gait impairments, the diversity of conventional gait training interventions appears to be more effective than robotic-assisted gait training for facilitating returns in walking ability.