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Gait improvements by assisting hip movements with the robot in children with cerebral palsy: a pilot randomized controlled trial

机译:通过辅助脑瘫患儿的儿童的机器人辅助臀部运动来实现改进:试点随机对照试验

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Recently, rehabilitation robots are expected to improve the gait of cerebral palsy (CP) children. However, only few previous studies have reported the kinematic and kinetic changes by using wearable exoskeleton robots. The aim of this study was to investigate the change in gait parameters in CP children by training with the wearable robot-assisted gait training. 10 spastic CP children with Gross Motor Function Classification Scale levels I-III completed a sham-controlled crossover randomized trial. Robot-assisted gait training (RAGT) and non-assisted gait training (NAGT) were performed on the treadmill with the Honda Walking Assist (HWA) in two different days. To examine the carry-over effect from treadmill walking to overground walking, participants also performed 5.5?m overground-walks without the HWA before and after treadmill training (pre- and post-trial). During treadmill walking, peak of both hip and knee angles were measured. Also, we calculated the limb symmetry of hip range of motion. In addition, gait speed and ground reaction force were measured in overground trials. The maximum hip angle on the limb with fewer hip movements, which was defined as the affected limb, showed a significant interaction between ASSIST (RAGT and NAGT) and TIME (pre- and post-trial) (p??0.05). Limb symmetry significantly improved after RAGT (p??0.05), but not in NAGT. Furthermore, the affected limb showed a significant increase in the positive peak of the anterior-posterior ground reaction force during 70–100% of the gait cycle (p??0.05). However, there was no change in gait speed. By assisting the both hip movements with the HWA, maximum hip flexion and extension angle of the affected limb improved. Also, limb symmetry and propulsion force of the affected limb improved. Our results suggest that assisting both hip movements with the HWA might be an effective method for improving gait in CP children. UMIN-CTR, UMIN000030667.
机译:最近,预计康复机器人将改善脑瘫(CP)儿童的步态。然而,以前的少数研究报告了通过使用可穿戴外骨骼机器人的运动和动力学的变化。本研究的目的是通过培训可穿戴机器人辅助步态培训来研究CP儿童步态参数的变化。 10痉挛性CP带有总电机功能分类规模级别I-III完成了假控的交叉随机试验。在两天不同的日子里,在跑步机上对跑步机进行了机器人辅助步态培训(RAG)和非辅助步态培训(NAGT)。要检查从跑步机行走到地下行走的扶腹效果,参与者还在跑步机培训前后没有香港会议(审判前后),参加人员在没有香港会路的情况下进行5.5?在跑步机行走期间,测量臀部和膝关节角的峰值。此外,我们计算了HIP运动范围的肢体对称性。此外,在地下试验中测量步态速度和地面反作用力。肢体上的最大臀角度与受影响的肢体定义的臀部较少,显示出辅助(ragt和nagt)和时间之间的显着相互作用(预后和试验期)(p?<?0.05)。在RAGT后,肢体对称性显着改善(P?<0.05),但不在NAGT中。此外,受影响的肢体显示出在步态循环的70-100%的前后地面反作用力的正峰值的显着增加(P?<β05)。但是,步态速度没有变化。通过辅助HWA的两个髋关节运动,受影响的肢体的最大臀部屈曲和延伸角改善。此外,受影响的肢体的肢体对称性和推进力得到改善。我们的研究结果表明,协助与HWA的两个髋关节运动可能是改善CP儿童步态的有效方法。 UMIN-CTR,UMIN000030667。

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