跑步機合併縣吊系統於社經系統損傷患者步行訓練之效果

The Effect of Ambulation Training with Treadmill and Partial Weight Support in Patients with Neurological Lesions

劉娟妃(Chuan-Fei Liu) ； 成戎珠(Rong-Ju Cherng)

《物理治療》 29卷6期 (2004/12) Pp. 429-438

摘要

醫療機構的跑步機設施，傳統上多於病患的體能改善(reconditioning)訓練。近年來已有研究者將跑步機與縣吊系統結合起來運用於各類社經疾患之步行訓練，初步的研究結果顯示此方法具有不錯的療效。本文藉由文獻回顧方式介紹跑步機合併縣吊系統運用於各類社經疾患之步行訓練的緣起、動物實驗之模式、理論基礎及其應用於脊髓損傷、腦中風與腦性痳痺患者的研究結果。跑步機合併縣吊系統運用於社經受損患者之步行訓練是源泉自於脊髓橫斷動物的步行訓練模式；其原理爲跑步機可提供動態且重複的步行環境，而縣吊系統可提供部分體重支撐、減少下肢之承重，進而減少牽張反射之誘發，並提供平衡支持之功效，可讓尚無法獨立行走的患者做出與一般平地步行相似的動作，符合現今動作學習理論中強調訓練需符合作業特定性(task-specific)的原則。跑步機合併縣吊系統於神經操作患者之步行訓練效果包括步行速度與耐力的增加、平衡與功能的改善等；然而步行訓練效果會受到訓練時之受傷的階段、受傷的嚴重性與訓練的方式的影響。因此，跑步機合併縣吊系統運用於步行訓練所衍生出來的相關議題，仍有待未來作進一步地研究探討。

關鍵字

步行訓練 ； 跑步機 ； 縣吊系統 ； 動作學習 ； 作業取向學習

並列摘要

Treadmill has been traditionally used in the medical setting for patients’ reconditioning training. Recently, it has been combined with suspension system and applied for ambulation training in patients with neurological lesions. The reported preliminary effects of such training program were promising. This paper, based on literature reviews, aimed to introduce the origin, animal experiments, the theoretical basis of such ambulation training method; its effects on the patients with spinal cord injury, stroke and cerebral palsy were also reviewed. The ambulation training with treadmill combined with suspension system origins from the experimental model of transected spinal cord animals. Treadmill with its rolling belt can provide the subject with repetitive ambulation chances. The suspension system with its belt and harness can reduce the weight support of lower extremities, and provide balance assistance. Thus, the combination of treadmill and suspension system allows the patients who are not able to independently ambulate to practice ambulation. The concept of such training method is also consistent with the task-specific principle of contemporary motor learning theory. The reported effects of ambulation training with treadmill and partial weight support include increases in gait velocity, endurance, and improvement in balance and walking function, etc. However, the effects seemed to be influenced by the stage and severity of injury, and training protocol. Due to limited study reports and limitation of the experimental designs of reported research, the themes concerned with the effect and the optimal training protocol of such ambulation training method still merit further investigation.

並列關鍵字

Ambulation training ； Treadmill ； Suspension system ； Motor learning ； Task-oriented training