Effect of Robot-assisted Gait Training on Walking Ability in Patients with Incomplete Spinal Cord Injury
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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.
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关键词:
- 康复机器人辅助步行训练 /
- 地面步行训练 /
- 脊髓损伤 /
- 步行能力
Abstract: In order to determine the effect of robot-assisted gait training (RAGT) on walking ability in patients with incomplete spinal cord injury (ISCI), 16 patients were randomly grouped into either the control group receiving conventional rehabilitation and over-ground training or the test group receiving conventional rehabilitation and RAGT. Low extremity motor score (LEMS) and walking index for spinal cord injury II (WISCI II) were evaluated before treatment and after 4-week, 8-week and 12-week treatment, respectively. Both the LEMS in the two groups significantly increased after 4-week, 8-week and 12-week treatment (P < 0.05), but no significant differences were found between the two groups (P>0.05). The WISCI II in control group were significantly improved after 4-week, 8-week and 12-week treatment (P < 0.05), while the values for WISCI II in test group were significantly improved after 8-week and 12-week treatment (P < 0.05). But only after 12-week treatment, the WISCI II in test group was significantly greater than that in control group (P < 0.05). In conclusion, RAGT might be not superior in improvement of muscle strength, but be superior in increase of walking ability when compared to over-ground training.1) 本文责任编委 王卫群 -
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) 男 6 2 女 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 
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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值 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值 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.
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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值 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值 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.
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