19例脑卒中患者EksoNR下肢外骨骼机器人辅助步态训练增强康复效果

Agnieszka Wiśniowska-Szurlej, Natalia Wołoszyn, Justyna Brożonowicz, Gabriela Ciąpała, Kamil Pietryka, Joanna Grzegorczyk, Justyna Leszczak, Agnieszka Ćwirlej-Sozańska, Bernard Sozański, Bartosz Korczowski
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摘要

脑卒中是导致长期残疾的主要原因,常导致活动能力受损和步态异常,需要有效的康复方法。机器人辅助步态训练(RAGT)提供精确的控制和密集的,特定任务的训练。EksoNR外骨骼显示出促进步态恢复的潜力。本研究利用EksoNR评估RAGT在19例脑卒中患者康复中的疗效和耐受性。材料和方法采用前瞻性、非随机、观察性研究设计,采用单组方便样本。该研究包括19名中风患者,他们接受了为期4周的康复计划。基线和康复后评估采用选定的国际功能、残疾和健康分类(ICF)代码、外骨骼训练期间获得的步态外骨骼参数(步数、行走时间、垂直时间)和定时起身和行走测试(TUG)进行。结果:该研究显示,除D530如厕外,所有分析的ICF类别均有统计学显著改善,表明功能增强。活动度和参与性改善最显著的是D410改变基本体位(-0.84±0.60)和D450步行(-0.84±0.60)。此外,步态分析显示,步数(506.79±252.49)、行走时间(13.02±7.91)和直立时间(11.82±9.21)显著增强(p>0.001)。TUG测试也显示患者活动能力有统计学意义的改善(p=0.005)。结论:本研究支持先前的研究结果,表明使用EksoNR下肢外骨骼的RAGT可以改善脑卒中患者的步态和功能状态,同时耐受性良好。结果强调了这种方法在改善康复结果方面的潜力。
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Enhanced Rehabilitation Outcomes of Robotic-Assisted Gait Training with EksoNR Lower Extremity Exoskeleton in 19 Stroke Patients.

BACKGROUND Stroke is a leading cause of long-term disability, often resulting in impaired mobility and gait abnormalities, necessitating effective rehabilitation approaches. Robotic-assisted gait training (RAGT) offers precise control and intensive, task-specific training. The EksoNR exoskeleton shows potential in facilitating gait recovery. This study assesses the efficacy and tolerability of RAGT using EksoNR in the rehabilitation of 19 stroke patients. MATERIAL AND METHODS A prospective nonrandomized, observational study design was employed with a single group convenience sample. The study included 19 individuals post-stroke, who underwent a 4-week rehabilitation program. Baseline and post-rehabilitation assessments were conducted using selected International Classification of Functioning, Disability and Health (ICF) codes, gait exoskeleton parameters (number of steps, walking time, time of verticalization) obtained during the exoskeleton sessions, and the Timed Up and Go Test (TUG). RESULTS The study revealed statistically significant improvements in all analyzed ICF categories, except for D530 Toileting, indicating enhanced functioning. The most notable improvements in activity and participation were observed in the categories of D410 Changing basic body position (-0.84±0.60) and D450 Walking (-0.84±0.60). Additionally, gait analysis demonstrated significant enhancements in the number of steps (difference of 506.79±252.49), walking time (13.02±7.91), and time of verticalization (11.82±9.21) (p>0.001). The TUG test also showed a statistically significant improvement in mobility (p=0.005). CONCLUSIONS This study supports previous findings, demonstrating that RAGT using the EksoNR lower extremity exoskeleton improves gait and functional status in stroke patients, while being well tolerated. The results highlight the potential of this approach for improved rehabilitation outcomes.

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