穿戴式外骨骼助行器改善脑卒中患者步行能力的随机对照研究

关键词：脑卒中  步行辅具  步行能力

Keywords:stroke  assistive devices  walking ability

摘要：

      摘要 目的：探究穿戴式外骨骼助行器对脑卒中患者步行能力的影响。 方法：将30例脑卒中患者随机分为观察组（15例）和对照组（15例）。两组均接受临床药物治疗和常规康复训练，观察组使用Kickstart穿戴式外骨骼助行器进行步行训练；对照组进行常规步行训练；每组步行累计时长≥1h/d，5d/周，共4周。两组干预前后测试内容包括计时“起立-行走”测试（TUG）、10m步行测试（10MWT）、6min步行测试（6MWT）和三维步态测试。 结果：干预前后的组内比较，观察组的TUG、10MWT、6MWT有极显著性差异（P<0.01），步速、步幅和健侧步长具有显著性差异（P<0.05），步态周期、步频和患侧步长无显著性差异（P＞0.05）；对照组的TUG、6MWT有极显著性差异（P<0.01），10MWT有显著性差异（P<0.05），步态参数指标均无显著性差异（P＞0.05）。两组干预前后差值组间比较，TUG和6MWT有显著性差异（P<0.05），而10MWT和所有步态参数指标无显著性差异（P＞0.05）。 结论：4周Kickstart穿戴式外骨骼助行器的步行训练对脑卒中患者的步行能力有一定的积极影响。

Abstract:

      Abstract Objective： The purpose of this study was to investigate the effect of Kickstart walk assist system on walking function in stroke patients. Method： A total of 30 stroke inpatients were randomly divided into experimental group (n=15) and control group (n=15). Both groups received clinical drug treatment and conventional rehabilitation treatment. The experimental group received walking training with Kickstart walk assist system， while the control group received conventional walking training (without any assistive devices). Both groups were trained for daily accumulated walking more than 1 hour， 5 days per week for 4 weeks. All patients were assessed including the timed “up and go” test (TUG)， the 10-meter walking test (10MWT)， the 6-minute walking test (6MWT)， and the three-dimensional gait analysis test before and after the 4-week intervention. Result： After intervention， TUG， 10MWT and 6WMT in the experimental group had a significantly statistic difference (P<0.01)， and the experimental group showed statistically significant improvements in the stride speed， stride and contralateral step(P<0.05)， the gait circle， cadence and affected step in the experimental group had no significantly statistic difference (P>0.05). TUG and 6WMT in the control group had a significantly statistic difference (P<0.01)， 10MWT showed statistically significant difference in the control group (P<0.05)， all of the temporal parameters in the control group had no significantly statistic difference(P>0.05). As for the differences between the experimental and the control group， there were significantly statistic differences in TUG， 6WMT (P<0.05)， but no statistically significant difference were found in 10MWT and all of the temporal parameters (P>0.05). Conclusion： The Kickstart walking assist system has a potentially positive effect on the walking ability in stroke patients.