基于运动预测的新型实时辅助臀部可穿戴外骨骼机器人用于亚急性中风下肢康复:一项单盲、随机对照试验。

IF 2.2 3区 医学 Q3 CLINICAL NEUROLOGY
Yongjie Li, Shuwen Luo, Runxin Luo, Hongju Liu
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引用次数: 0

摘要

背景:基于脑卒中患者运动预测,开发了一种新型的实时辅助可穿戴髋关节外骨骼机器人,但其康复效果尚不明确。本研究旨在探讨该机器人对亚急性脑卒中患者下肢康复的影响,重点关注步态功能,下肢运动障碍和平衡被认为是次要结局。方法:选取40例亚急性脑卒中患者,随机分为机器人辅助步态训练组(RAGT)和对照组。对照组接受常规康复治疗和治疗师辅助的步态训练,RAGT组接受常规治疗并辅以机器人辅助训练。每组参加干预,每周五天,为期四周。主要结果包括步态运动学(髋关节-膝关节-踝关节角度)、动力学(峰值垂直地面反作用力(vGRF))和时空参数。采用不对称指数(ASI)计算步态运动学和动力学变量的不对称性。次要结果包括Fugl-Meyer下肢评估量表(FMA-LE)、Berg平衡量表(BBS)和定时起身测试(TUGT)。在基线和干预后四周对所有措施进行评估。结果:在主要结果方面,RAGT组在干预前和干预后的步态速度、节奏、双肢髋关节屈曲/伸展峰值和膝关节屈曲峰值以及父母侧vGRF峰值均有显著改善。干预后组间比较显示,RAGT组患者的步态速度、步幅、步长、双下肢髋屈伸峰值和膝关节屈伸峰值以及麻痹侧vGRF峰值均高于对照组(p)。结论:基于运动预测的新型实时辅助可穿戴髋关节外骨骼机器人可有效改善亚急性脑卒中患者的步态功能、下肢运动障碍和平衡能力。试验注册:www.chictr.org.cn(注册号:ChiCTR2300074562)。报名日期:2023年8月9日。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A novel real-time assistive hip-wearable exoskeleton robot based on motion prediction for lower extremity rehabilitation in subacute stroke: a single-blinded, randomized controlled trial.

Background: A novel real-time assistive hip-wearable exoskeleton robot is developed based on motion prediction for stroke patients, however its rehabilitation efficacy is not yet clear.This study aimed to explore the effect of this robot on lower extremity rehabilitation in subacute stroke patients, focusing on gait function, with lower limb motor impairment, and balance being considered secondary outcomes.

Methods: The investigation enrolled 40 subacute stroke patients, randomly assigned to two groups: the robot-assisted gait training(RAGT) group and a control group.The control group underwent conventional rehabilitation and therapist-assisted gait training, while the RAGT group received conventional therapy supplemented with robot-assisted training. Each group participated in the intervention five days a week for four weeks.The primary outcomes comprised gait kinematics(hip-knee-ankle angles), kinetics[peak vertical ground reaction force(vGRF)], and spatiotemporal parameters. Asymmetry in gait kinematic and kinetic variables was calculated using the asymmetry index(ASI). Secondary outcomes included the Fugl-Meyer Assessment for Lower Extremity Scale(FMA-LE), the Berg Balance Scale(BBS), and the Timed Up and Go Test(TUGT). All measures were evaluated at baseline and at four weeks post-intervention.

Results: With respect to primary outcomes, the RAGT group exhibited marked improvements in gait speed, cadence, peak hip flexion/extension and knee flexion in both limbs, and in peak vGRF on the paretic side pre- and post-intervention. Post-intervention between-group comparisons revealed that the RAGT group achieved higher gait speed, cadence, step length, peak hip flexion/extension and peak knee flexion in both lower limbs, and peak vGRF on the paretic side than the control group(P<0.05). Additionally, the RAGT group exhibited significantly lower ASI values for peak hip flexion/extension, peak knee flexion, and peak vGRF post-intervention compared to controls(P<0.05). Regarding secondary outcomes, both groups showed significant improvements in FMA-LE and BBS scores from pre- to post-intervention(P<0.05).Furthermore, post-intervention analyses indicated that the RAGT group outperformed the control group on the FMA-LE, BBS, and TUGT measures (P<0.05).

Conclusion: The novel real-time assistive hip-wearable exoskeleton robot based on motion prediction is effective for improving gait function, lower limb motor impairment and balance ability in subacute stroke patients.

Trial registration: www.chictr.org.cn (registrationnumber: ChiCTR2300074562). Registration date: 09/08/2023.

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来源期刊
BMC Neurology
BMC Neurology 医学-临床神经学
CiteScore
4.20
自引率
0.00%
发文量
428
审稿时长
3-8 weeks
期刊介绍: BMC Neurology is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of neurological disorders, as well as related molecular genetics, pathophysiology, and epidemiology.
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