固定式機器人輔助步態訓練對於中風患者步態功能之療效：統合分析與系統性回顧

背景與目的：中風後的行走能力受損是導致失能的主要原因，使中風患者無法安全有效的執行日常生活活動，進而影響其獨立生活能力和社交參與，因此改善行走能力是中風復健的重要目標。機器人輔助步態訓練是種新型的介入方式，可提供患者高強度、反覆、長時間的動作練習，強化復健運動訓練的效果。本研究目的為利用統合分析與系統性回顧，探討機器人輔助步態訓練對於中風患者在步態功能的改善成效是否優於一般步態訓練。方法：本研究搜尋相關電子資料庫，納入2011年2月至2021年3月的隨機對照試驗。使用皮卓量表與新版牛津實證醫學中心證據等級分析納入文獻的品質與建議等級。以Review Manager Version 5.4軟體進行統合分析。結果：本研究納入15篇文獻進行統合分析和文獻回顧，統合分析結果顯示，中風患者經過機器人輔助步態訓練後，於功能性步行量表（mean difference [MD] = 0.34, 95% confidence interval [CI]: -0.20 to 0.88, p = 0.22）、步行速度（MD = -0.01, 95% CI: -0.06 to 0.03, p = 0.52）、六分鐘行走測試（MD = 4.36, 95% CI: -20.20 to 28.93, p =0.73）、計時起走測試（MD = 1.91, 95% CI: -5.63 to 9.45, p = 0.62）及瑞佛米德活動功能量表（MD = 0.87, 95% CI:-1.51 to 3.26, p = 0.47）與一般步態訓練相比皆無顯著差異性。針對中風後三個月內的中風患者，在功能性步行量表、步行速度、六分鐘行走測試、瑞佛米德活動功能量表也皆無顯著差異性。結論：機器人輔助步態訓練對於中風患者在步態功能的改善成效並未優於一般步態訓練。

關鍵字

機器人輔助步態訓練；步態功能；中風

並列摘要

Background and Purpose: Gait dysfunction after stroke cause difficulties in activities of daily living and mobility, which impacts the quality of life and social engagement. Restoration of gait is therefore a major goal in stroke rehabilitation. Robot-assisted gait training is an emerging training to provide safe, intensive, and task-specific repetitive practice for improving gait function. The purpose of this study was to use a meta-analytical approach to compare the effects of robot-assisted gait training with conventional gait training and systematically review the evidence of robot-assisted gait training on gait function in people with stroke. Methods: A systematic search of related databases from February, 2011 to March, 2021 was conducted. The quality of eligible randomized controlled trials was evaluated using PEDro and Oxford classification. Meta-analysis was conducted using Review Manager Version 5.4 software. Results: Fifteen studies were included in meta-analysis and systematic review. The results of meta-analysis showed that there is no significant difference between robot-assisted gait training and conventional gait training in Functional Ambulation Category (mean difference [MD] = 0.34, 95% confidence interval [CI]: -0.20 to 0.88, p = 0.22), walking speed (MD = -0.01, 95% CI: -0.06 to 0.03, p = 0.52), six-minute walk test (MD = 4.36, 95% CI: -20.20 to 28.93, p = 0.73), time up and go test (MD = 1.91, 95% CI: -5.63 to 9.45, p = 0.62), and Rivermead mobility index (MD = 0.87, 95% CI: -1.51 to 3.26, p = 0.47) in people with stroke. Besides, people in the first 3 months after stroke did not benefit more from robot-assisted gait training. Conclusion: Robot-assisted gait training was not superior to conventional gait training in improving gait function in patients with stroke.

並列關鍵字

Robot-assisted gait training ； Gait function ； Stroke

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