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康复机器人辅助步行训练对不完全性脊髓损伤患者步行能力的影响

林海丹 张韬 陈青 李宏伟 白定群

林海丹, 张韬, 陈青, 李宏伟, 白定群. 康复机器人辅助步行训练对不完全性脊髓损伤患者步行能力的影响. 自动化学报, 2016, 42(12): 1832-1838. doi: 10.16383/j.aas.2016.c160173
引用本文: 林海丹, 张韬, 陈青, 李宏伟, 白定群. 康复机器人辅助步行训练对不完全性脊髓损伤患者步行能力的影响. 自动化学报, 2016, 42(12): 1832-1838. doi: 10.16383/j.aas.2016.c160173
LIN Hai-Dan, ZHANG Tao, CHEN Qing, LI Hong-Wei, BAI Ding-Qun. Effect of Robot-assisted Gait Training on Walking Ability in Patients with Incomplete Spinal Cord Injury. ACTA AUTOMATICA SINICA, 2016, 42(12): 1832-1838. doi: 10.16383/j.aas.2016.c160173
Citation: LIN Hai-Dan, ZHANG Tao, CHEN Qing, LI Hong-Wei, BAI Ding-Qun. Effect of Robot-assisted Gait Training on Walking Ability in Patients with Incomplete Spinal Cord Injury. ACTA AUTOMATICA SINICA, 2016, 42(12): 1832-1838. doi: 10.16383/j.aas.2016.c160173

康复机器人辅助步行训练对不完全性脊髓损伤患者步行能力的影响

doi: 10.16383/j.aas.2016.c160173
基金项目: 

重庆市集成示范计划项目 cstc2015jcsf10012

详细信息
    作者简介:

    林海丹  重庆医科大学康复医学与理疗学专业博士研究生.2010年获四川大学硕士学位.主要研究方向为脊髓损伤的康复.E-mail:hopelam@126.com

    张韬  湖南中医药大学康复治疗学本科生.重庆医科大学附属第一医院康复医学科物理治疗师.主要研究方向为步态分析及步行功能重建, 动作分析技术.E-mail:van mozart@foxmail.com

    陈青  重庆医科大学附属第一医院康复医学科医师.于2015年在重庆医科大学获得医学硕士学位.主要研究方向为脊髓损伤的康复, 光动力疗法.E-mail:cqcq20123634@163.com

    李宏伟  重庆医科大学附属第一医院康复医学科物理治疗师.于2014年在香港理工大学获得理学硕士学位.主要研究方向为运动损伤的预防及物理治疗.E-mail:lhwlove@163.com

    通讯作者:

    白定群  医学博士, 重庆医科大学附属第一医院康复医学科副主任医师.主要研究方向为脊髓损伤的康复.本文通信作者.E-mail:baidingqun2014@163.com

Effect of Robot-assisted Gait Training on Walking Ability in Patients with Incomplete Spinal Cord Injury

Funds: 

Supported by Integrated Demonstration Project of Chongqing cstc2015jcsf10012

More Information
    Author Bio:

     Ph. D. candidate in physical medicine and rehabilitation at Chongqing Medical University. She received her master degree from Sichuan University in 2010. Her main research interest is rehabilitation in spinal cord injury

     Undergraduate in rehabilitation therapy at Hunan University of Chinese Medicine and physical therapist in the Department of Rehabilitation Medicine, the First Affiliated Hospital of Chongqing Medical University. His research interest covers gait analysis, reconstruction of walking function and motion analysis technology

     Physician in the Department of Rehabilitation Medicine, the First Affiliated Hospital of Chongqing Medical University. She received her master of medicine degree from the Chongqing Medical University in 2015. Her research interest covers rehabilitation in spinalcord injury and photodynamic therapy

     Physical therapist in the Department of Rehabilitation Medicine, the First Affiliated Hospital of Chongqing Medical University. He received his bachelor degree from the Hong Kong Polytechnic University in 2014. His research interest covers prevention and physiotherapy in sports injury

    Corresponding author: BAI Ding-Qun Doctor of medicine, associate chief physician in the Department of Rehabilitation Medicine, the First Affiliated Hospital of Chongqing Medical University. His main research interest is rehabilitation in spinal cord injury. Corresponding author of this paper
  • 摘要: 为探讨康复机器人辅助步行训练(Robot-assisted gait training,RAGT)对不完全性脊髓损伤(Incomplete spinal cord injury,ISCI)患者步行能力的影响,将16例ISCI患者随机分配至对照组(常规康复治疗+地面步行训练)及试验组(常规康复治疗+RAGT).治疗前及治疗4周、8周、12周后,分别进行下肢运动功能评分(Low extremity motor score,LEMS)及脊髓损伤步行指数II(Walking index for spinal cord injury II,WISCI II)评定.治疗后,两组患者LEMS均有提高(P < 0.05),但试验组LEMS与对照组比较差异无统计学意义(P>0.05).对照组治疗后各时间点WISCI II均较治疗前改善(P < 0.05),试验组在治疗8周及12周后WISCI II较治疗前改善(P < 0.05),但试验组WISCI II在训练12周后较对照组有明显提高(P < 0.05).RAGT与地面步行训练在提高肌力上比较无明显差异,但在改善步行能力上RAGT优于地面步行训练.
    1)  本文责任编委  王卫群
  • 图  1  A3步行康复机器人

    Fig.  1  A3 walking-rehabilitation robot

    表  1  2组患者一般资料比较

    Table  1  The comparison of general data between the control and test groups

    比较项目 对照组 试验组
    例数 8 8
    性别(例数) 6 2
    7 1
    年龄(岁) 47.50±5.53 44.00±6.02
    病程(月) 3.19±1.22 3.25±0.93
    导致SCI的
    疾病(例)
    脊柱骨折 6 6
    脊髓血管病变 1 1
    脊髓炎 0 1
    鞘膜瘤 1 0
    损伤节段
    (例)
    C4 1 2
    T10 2 1
    T11 1 1
    T12 1 1
    L1 1 3
    L2 2 0
    损伤程度(例) C级 5 6
    D级 3 2
    下载: 导出CSV

    表  2  2组患者LEMS比较

    Table  2  The comparison of LEMS between the control and test groups

    组别 治疗前 治疗4周后 治疗8周后 治疗12周后 F P
    对照组 19.625±8.193 21.750±7.797# 23.000±7.856# 24.125±7.736# 22.996 0.000*
    试验组 15.125±12.287 18.875±13.830# 20.750±14.665# 22.750±15.276# 22.996 0.000*
    F 0.743 0.262 0.146 0.052
    P 0.403Δ 0.616Δ 0.708Δ 0.824Δ
    *: P=0.000, 对照组及试验组的LEMS在治疗前后不同时间点上不全相同, 差异有统计学意义.
    #:治疗后与治疗前比较, P < 0.05, 差异有统计学意义.
    Δ:试验组与对照组比较, P > 0.05, 差异无统计学意义.
    下载: 导出CSV

    表  3  2组患者WISCI Ⅱ比较

    Table  3  The comparison of WISCI Ⅱ between the control and test groups

    组别 治疗前 治疗4周后 治疗8周后 治疗12周后 F P
    对照组 0.500±0.535 2.500±1.414# 5.500±3.162# 7.250±4.234# 22.831 0.000*
    试验组 2.250±3.882 7.500±7.387 10.875±6.664# 13.750±5.036# 22.831 0.000*
    F 1.595 3.535 4.248 7.809
    P 0.227 0.081 0.058 0.014Δ
    *: P=0.000, 对照组及试验组的WISCI Ⅱ在治疗前后不同时间点上不全相同, 差异有统计学意义.
    #:治疗后与治疗前比较, P < 0.05, 差异有统计学意义.
    Δ:试验组与对照组比较, P < 0.05, 差异有统计学意义.
    下载: 导出CSV
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