Neurorehabilitation using a voluntary driven exoskeletal robot improves trunk function in patients with chronic spinal cord injury: a single-arm study  

作　　者：Hiroki Okawara Syoichi Tashiro Tomonori Sawada Keiko Sugai Kohei Matsubayashi Michiyuki Kawakami Satoshi Nori Osahiko Tsuji Narihito Nagoshi Morio Matsumoto Masaya Nakamura 

机构地区：[1]Department of Orthopaedic Surgery,Keio University School of Medicine,Tokyo,Japan [2]Department of Rehabilitation Medicine,Keio University School of Medicine,Tokyo,Japan [3]Department of Orthopedic Surgery,National Hospital Organization,Murayama Medical Center,Tokyo,Japan

出　　处：《Neural Regeneration Research》2022年第2期427-432,共6页中国神经再生研究（英文版）

基　　金：supported by the Uehara Memorial foundation,Japan Science and Technology Agency,No.05-001-0002;Japan Agency for Medical Research and Development,No.19bk0104017h00029(both to MN)。

摘　　要：Body weight-supported treadmill training with the voluntary driven exoskeleton(VDE-BWSTT) has been shown to improve the gait function of patients with chronic spinal cord injury. However, little is known whether VDE-BWSTT can effectively improve the trunk function of patients with chronic spinal cord injury. In this open-label, single-arm study, nine patients with chronic spinal cord injury at the cervical or thoracic level(six males and three females, aged 37.8 ± 15.6 years, and time since injury 51.1 ± 31.8 months) who underwent outpatient VDE-BWSTT training program at Keio University Hospital, Japan from September 2017 to March 2019 were included. All patients underwent twenty 60-minute gait training sessions using VDE. Trunk muscular strength, i.e., the maximum force against which patient could maintain a sitting posture without any support, was evaluated in four directions: anterior, posterior, and lateral(right and left) after 10 and 20 training sessions. After intervention, lateral muscular strength significantly improved. In addition, a significant positive correlation was detected between the change in lateral trunk muscular strength after 20 training sessions relative to baseline and gait speed. The change in trunk muscular strength after 20 training sessions relative to baseline was greatly correlated with patient age. This suggests that older adult patients with chronic spinal cord injury achieved a greater improvement in trunk muscle strength following VDE-BWSTT. All these findings suggest that VDE-BWSTT can improve the trunk function of patients with chronic spinal cord injury and the effect might be greater in older adult patients. The study was approved by the Keio University of Medicine Ethics Committee(IRB No. 20150355-3) on September 26, 2017.

关 键 词：body weight-supported treadmill training gait disorders hybrid assistive limb NEUROLOGIC neurophysiotherapy postural balance precision medicine robot-assisted gait training robotics spinal cord injury TRUNK 

分 类 号：R651.2[医药卫生—外科学]