Effects of lower-extremity exoskeleton robot-assisted dual-task training versus walking training on gait and postural control after stroke: A randomized controlled trial.
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Abstract
Background: Therapeutic tools are critical for poststroke rehabilitation. The potential benefits of dual-task training assisted by a lower-extremity exoskeleton robot to enhance gait and postural control have yet to be studied.
Objective: To determine the effects of lower-extremity exoskeleton robot-assisted dual-task training on gait and postural control after stroke.
Setting: Outpatient clinic and ward, Department of Rehabilitation Medicine, Huadong Hospital affiliated with Fudan University.
Participants: Forty-four participants in the recovery and sequela phases of stroke with deficits in gait and postural control.
Interventions: Participants were randomly assigned to two groups: lower-extremity exoskeleton robot-assisted walking cognitive dual-task training (experimental group) or lower-extremity exoskeleton robot-assisted walking training (control group). Each participant received 40 minutes per intervention, 1 time per day, 6 times per week for 3 weeks.
Main outcome measures: The primary outcome was gait variability performance. The secondary outcomes included the Timed Up and Go, Berg Balance Scale, Montreal Cognitive Assessment, Fugl-Meyer assessment of lower extremity, and International Classification of Functioning, Disability and Health-activities and participation assessment scale.
Results: Individuals who participated in exoskeleton robot-assisted walking cognitive dual-task training improved more than those in the control group in partial gait variability performance analysis, Timed Up and Go test, Berg Balance Scale, and Fugl-Meyer assessment for the lower extremities (p < .05).
Conclusions: Compared to lower-extremity exoskeleton robot-assisted walking training, robot-assisted dual-task training improves gait and postural control, walking, balance, and lower extremity motor function in survivors of stroke.
背景：治疗工具对脑卒中后康复至关重要。由下肢外骨骼机器人辅助的双任务训练对增强步态和姿势控制的潜在益处尚未研究。目的：探讨下肢外骨骼机器人辅助双任务训练对脑卒中后步态和姿势控制的影响。设计：单盲、随机对照试验。单位：复旦大学附属华东医院康复内科门诊及病房。参与者：44名在步态和姿势控制方面有缺陷的中风恢复期和后遗症期的参与者。干预措施：参与者被随机分为两组：下肢外骨骼机器人辅助行走认知双任务训练组（实验组）或下肢外骨骼机器人辅助行走训练组（对照组）。每位参与者每次干预40分钟，每天1次，每周6次，持续3周。主要结局指标：主要结局指标为步态变异性表现。次要结果包括Timed Up and Go、Berg平衡量表、Montreal认知评估、Fugl-Meyer下肢评估和国际功能、残疾和健康分类-活动和参与评估量表。结果：参与外骨骼机器人辅助行走认知双任务训练的个体在部分步态变异性性能分析、Timed Up and Go测试、Berg平衡量表和下肢Fugl-Meyer评估方面比对照组改善更多(p)。与下肢外骨骼机器人辅助行走训练相比，机器人辅助双任务训练可以改善中风幸存者的步态和姿势控制、行走、平衡和下肢运动功能。
期刊介绍：
Topics covered include acute and chronic musculoskeletal disorders and pain, neurologic conditions involving the central and peripheral nervous systems, rehabilitation of impairments associated with disabilities in adults and children, and neurophysiology and electrodiagnosis. PM&R emphasizes principles of injury, function, and rehabilitation, and is designed to be relevant to practitioners and researchers in a variety of medical and surgical specialties and rehabilitation disciplines including allied health.
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