Ambulation training of neurological patients on the treadmill with a new Walking Assistance and Rehabilitation Device (WARD)
Ambulation training of neurological patients on the treadmill with a new Walking Assistance and Rehabilitation Device (WARD)
复制标题
DOI：
10.1038/sj.sc.3100821
复制
发表时间：
1999-05-01
期刊：
影响因子：
2.2
通讯作者：
Marchetti, M
中科院分区：
文献类型：
--
作者：
Gazzani, F;Bernardi, M;Marchetti, M
研究设计：患有神经性行走障碍的患者使用一种新的系统进行康复，该系统包括一种不断减轻体重的装置和一种跑步机：行走辅助和康复装置（WARD）。患者进行了评估之前和之后的康复与临床量表和生理measurements. Objective. To评估的有效性WARD在改善步行能力在这些patients.Setting：这项研究进行了临床环境（IRGCS S。Lucia，Rehabilitation Hospital，罗马，意大利）。方法：7名患者（6名脊髓损伤，1名脑损伤）在WARD接受了1-2个月的训练。在WARD培训期间，定期评估通过WARD对患者施加的体重恒定卸载（BWCU）。测量耗氧量、二氧化碳产生量和心率，以获得步行的能量和心脏成本。这些测量是在WARD以适当的跑步机速度（ATS）和在开放场地以最舒适的速度（MCS）行走时进行的。除了与行走能力相关的临床评分外，所有测量均在WARD训练期开始时（BWT）和结束时（EWT）进行。在EWT期间，患者在观察相同BWT条件（相同ATS和BWCU）的WARD下进行行走测试，称为开始条件第二次测量（BCSM）。结果：BWT与EWT比较，临床评分提高，ATS均增加，BWCU降低，BWCU降低，BWT与EWT比较，差异有统计学意义（P < 0. 05）。（4）所有患者在ATS下使用WARD行走时测量的行走能量成本（WEC）和行走心脏成本（WCC）均有所改善;（5）所有患者在开放视野中测量的WEC和WCC均有所改善。在BCSM的EWT发现的WEC rs ATS曲线被发现显着不同的BWT曲线，表现出重大的改善，由于WARD training.Conclusion：尽管由于样本量和功能amnesty规模的一些限制，这项研究已经证明，WARD训练是有效的，在提高患者的行走能力和效率。
Study design: Patients with neurological walking impairment were rehabilitated with a new system, consisting of an apparatus to constantly relieve the body weight and a treadmill: The Walking Assistance and Rehabilitation Device (WARD). Patients were evaluated before and after rehabilitation with clinical scales and physiological measurements.Objectives: To evaluate the effectiveness of the WARD in improving walking capability in these patients.Setting: The study was carried out in a clinical environment (IRGCS S. Lucia, Rehabilitation Hospital, Rome, Italy).Methods: Seven patients (six with spinal cord injuries, one with brain injury) underwent a 1-2 month training period with the WARD. During the WARD training the body weight constant unloading (BWCU) applied to the patient through the WARD was regularly evaluated. Oxygen consumption, carbon dioxide production and heart rate were measured in order to obtain energy and cardiac costs of walking. These measurements were carried out while walking with the WARD at an appropriate treadmill speed (ATS) and in the open field at the most comfortable speed (MCS). All measurements, in addition to clinical scores related to the walking capability, were carried out at the beginning of the WARD training period (BWT) and at the end (EWT). AL the EWT the patients were tested walking with the WARD observing the same BWT conditions (same ATS and BWCU), referred to as beginning conditions second measurements (BCSM). The relationships between physiological costs and ATS were described through second order polynomial regression curves and studied.Results: Comparing the data obtained at the BWT and EWT, the following results were found significantly different: (1) Clinical scores improved; (2) All patients increased their ATS; (3) The BWCU was reduced; (4) The Walking Energy Cost (WEC) and the Walking Cardiac Cost (WCC) measured when walking with the WARD at the ATS improved in all patients; and (5) The WEC and WCC measured in the open field improved in all patients. The WEC rs ATS curve found at the EWT in the BCSM was found significantly different from the BWT curve, demonstrating a major improvement due to the WARD training.Conclusion: Despite some limitations due to sample size and functional ambulation scale, this study has demonstrated that the WARD training is effective in improving the walking capability and efficiency of the patients.