應該可以順便認識一點有關但不熟悉的領域。
這篇是使用Hybrid Assistive Limb® (HAL)這款外骨骼機器人進行治療介入的研究，研究中僅收入6位CP受試者(年齡範圍13至24歲)，治療劑量為每周2-4次、每次20分鐘，總共4周12次。
療效看起來不錯，在多項療效評估指標都有進步。不過其實我對各種行走測驗認識不多，不太確定這樣的數值是否有達到顯著的臨床意義就是了。
但從行走距離的折線圖看來，我會覺得這樣的治療可能較適用於下肢損傷程度較輕的案例。但對於其他與行走有關的能力，應該還可以進一步探究。
此外，樣本數較小、沒有對照組，而且治療劑量也較低，都是這篇文獻中的限制。
以下是摘要。
Robot-assisted training using Hybrid Assistive Limb® for cerebral palsy.
Matsuda M1, Iwasaki N2, Mataki Y3, Mutsuzaki H4, Yoshikawa K5, Takahashi K5, Enomoto K5, Sano K5, Kubota A5, Nakayama T6, Nakayama J6, Ohguro H6, Mizukami M7, Tomita K8.Abstract
PURPOSE:
The Hybrid Assistive Limb® (HAL®, CYBERDYNE) is a wearable robot that provides assistance to a patient while they are walking, standing, and performing leg movements based on the wearer's intended movement. The effect of robot-assisted training using HAL® for cerebral palsy (CP) is unknown. Therefore, we assessed the effect of robot-assisted training using HAL® on patients with CP, and compared walking and gross motor abilities between pre-intervention and post-intervention.METHODS:
Six subjects with CP were included (mean age: 16.8 years; range: 13-24 years; Gross Motor Function Classification System levels II-IV: n = 1, 4, 1). Robot-assisted training using HAL® were performed 2-4 sessions per week, 20 min per session, within a 4 weeks period, 12 times in total. Outcome measures included gait speed, step length, cadence, single-leg support per gait cycle, hip and knee joint angle in stance, and swing phase per gait cycle, 6-minute walking distance (6 MD), physiological cost index (PCI), knee-extension strength, and Gross Motor Function Measure (GMFM).RESULTS:
There were significant increases in self-selected walking speed (SWS), cadence during SWS and maximum walking speed (MWS), single-leg support per gait cycle, hip joint angle in the swing phase, 6 MD, and GMFM. In contrast, gait speed during MWS, step length during SWS and MWS, hip and knee joint angle in the stance phase, knee joint angle in the swing phase, PCI, and knee-extension strength generally improved, but not significantly.CONCLUSION:
Robot-assisted training using HAL® may improve walking and gross motor abilities of patients with CP.Copyright © 2018 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.
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