使用自控式電動步行矯具(UPGO)作為慢性期中風患者之平衡及行走復健之效用

Effectiveness of User-controlled Powered Gait Orthoses (UPGO) for Balance and Gait Rehabilitation in Chronic Stroke Patients: A Case Study

李文舜(Wun-Shun Li)

指導教授 ： 章良渭 ； 黃義侑

國立臺灣大學/工學院/醫學工程學研究所/碩士(2018年)

https://doi.org/10.6342/NTU201801385

摘要

目的: 基於與市面上外骨骼機器人不同的設計理念，我們想證實此外骨骼裝置UPGO (User-Controlled-Powered-Gait-Orthosis) 的效率和效能是否能成為一個新的復健方法，使之改善病人的動作穩定度和行走姿勢的對稱，坐到站動作中雙腳的平均承重與平地行走中肢體的對稱…等。案例描述: 一名中風後偏癱23個月從醫院招募的男性，接受了包括前後評估一共13次平衡與步態的訓練回合。當實驗結束後，我們評估5次重複坐立（STS）測試、伯格平衡量表、POMA（Tinetti平衡評估）、起身行走計時、10公尺行走測試，並做力學和步態的分析。結果: 訓練結束時，患者在Berg平衡量表，POMA量表，10公尺定時行走測試，STS運動和步態表現得分均有所提高。2個月後的訪談中，患者主觀正向的表示所有日常表現都持續改善。討論: 這篇論文釐清我們裝置在中風患者的復健訓練中的可行性與可用性，使用UPGO作為恢復期中風患者復健方法或許能成為改善患者平衡能力可選擇的一種治療方法。結論: 在本案例研究中，受試者的平衡、步態表現、功能活動和動作控制得到改善。

關鍵字

中風 ； 偏癱 ； 復健 ； 外骨骼機器人裝置 ； 病人控制 ； 交替式步態矯形器 動力RGO

並列摘要

Background and Purpose. This case study describes the training effect in balance and gait rehabilitation that used an exoskeletal robot called User-controlled Powered Gait Orthoses (UPGO). This experiment also investigated the feasibility and usability in using UPGO device as rehabilitation method on chronic stroke patients. Case Descriptions. The subject who participated in this study was 50 years old. He is the first stroke survivor and had suffered subarachnoid hemorrhagic stroke with right hemiplegia for 23 months before admission to the study who participated in this total 13 evaluation and training sessions. After the training sessions, we evaluate subject in 5-repetition sit-to-stand (STS) test, Berg Balance Scale, POMA (Tinetti balance assessment), TUG, 10 MWT. Results. By the end of training sessions, patient had shown improvements in scores on Berg Balance Scale, POMA Scale, 10-m timed walking test, and STS movement and Gait performance. Discussion. Due to different design, we clarify the efficiency and effectiveness of using exoskeleton robot as a rehabilitation method could possibly improve user’s movement stability and postural symmetry, such as averaging the loading of legs, walking step length and evening the gait cycle when users perform Sit-to-Stand or Stand-to-Sit movement and level walking. Conclusion. Using UPGO as a rehabilitation method in recovery phase stroke patient may be a choice for improving user’s balance. In this case study, subject had improvements in gait performance, functional activities, balance, and motor control.

並列關鍵字

Stroke ； Hemiplegic ； Rehabilitation ； Exoskeletons ； Patient controlled ； Reciprocating gait orthosis ； Powered RGO

參考文獻

1. Feigin VL, Lawes CM, Bennett DA, Barker-Collo SL, Parag V. Worldwide

stroke incidence and early case fatality reported in 56 population-based studies: a systematic review. Lancet Neurol 2009, 8:355–369.

2. Duncan PW, Zorowitz R, Bates B, Choi JY, Glasberg JJ, Graham GD, Katz RC, Lamberty K, Reker D: Management of adult stroke rehabilitation care: a clinical practice guideline. Stroke 2005, 36:100–143.

3. Lord SE, McPherson K, McNaughton HK, Rochester L, Weatherall M: Community ambulation after stroke: how important and obtainable is it and what measures appear predictive? Arch Phys Med Rehabil 2004, 85:234–239.

4. Nilsson A, Vreede KS, Ha¨glund V, et al. Gait training early after stroke with a new exoskeleton-the hybrid assistive limb: a study of safety and feasibility. J Neuroeng Rehabil 2014;11:92