Clinical study on robotic gait training for hemiplegic patients with severe gait disturbance and brain activation during gait training

1.与安川电气公司合作完成了偏瘫患者步态严重障碍辅助机器人的临床模型。临床模型的修改包括髋关节轴线的位置、大腿袖带的模型、短腿支架的结构和跑步机，这些都是基于临床试验的结果。对有严重步态障碍的偏瘫患者进行机器人步态训练的初步研究表明，每周训练5次，每次20分钟，训练时间超过3周是必要的，并提高了他们的步态速度和下肢肌肉力量。步态辅助机器人有三种训练模式：主动步态、主动辅助步态和被动步态。照片地形图显示，被动步态模式下的机器人步态训练不会引起健康人和偏瘫患者的大脑激活，但在健康人和h…中，主动辅助步态模式下的机器人步态训练会诱导大脑激活。偏瘫患者较多。不能行走的患者在主动辅助步态模式下进行摄像地形图检查时，患侧大脑无激活或不对称激活。经过3周的机器人步态训练，在主动辅助步态模式下进行步态训练时，受试者受损大脑半球恢复了激活。对11例偏瘫患者进行了机器人步态训练的对比研究。纳入标准如下：受试者为严重步态障碍的偏瘫患者，发病时间<3个月，卒中损伤评定量表膝关节伸展试验<3分。机器人训练采用主动辅助步态模式，每天20min，每周5天，共4周。机器人训练组(n=9)在步态障碍和步速方面有明显改善。由于有几名患者退出了对照组，所以在一年后进行统计分析。较少

1. The clinical model of gait assist robot for hemiplegic patients with severe gait disturbance was completed in cooperation with Yaskawa Electric Company. Modifications of the clinical model contained the position of its hip joint axis, model of its thigh cuff, structure of its short leg brace, and treadmill, which were based on the results of clinical trials.2. The preliminary study on robotic gait training for hemiplegic patients with severe gait disturbance suggested that the training for 20 minutes, 5 times a week, more than 3 weeks, was necessary, and improved their gait speed and muscle strength of their lower extremities.3. The gait assist robot had three training modes: active gait, active assistive gait, and passive gait modes. Photo-topography revealed robotic gait training under the passive gait mode did not induce brain activation in healthy men and hemiplegic patients, but robotic gait training under the active assistive gait mode induced brain activation in healthy and h … More emiplegic patients.4. The patients who could not walk showed no activation of brain on the damaged hemisphere or asymmetrical activation when photo-topographic examinations were performed under the active assistive gait mode. After 3-week robotic gait training, they regained brain activation on the damaged hemisphere during gait training under the active assistive gait mode.5. The comparison study on robotic gait training was performed for 11 hemiplegic patients. The inclusion criteria were as follows: subjects were hemiplegic patients with severe gait disturbance, their duration from the onset was less than 3 months, and knee joint extension test of Stroke Impairment Assessment Set was less than 3. Robotic training consisted active assistive gait mode for 20 minutes a day, 5 days a week, and 4 weeks in total. The robotic training group (n=9) showed obvious improvement of gait disturbance and gait speed. Because several patients dropped out from the control group, the statistical analysis is performed after one year. Less