脊髓損傷患者使用動力外骨骼行走之短期訓練計畫成效：前驅研究

背景與目的：動力外骨骼藉由穿戴於使用者肢體上的機械結構來增進使用者的動作表現，這樣的技術很可能在未來脊髓損傷患者的步態訓練中扮演重要角色。本研究記錄了使用由財團法人工業技術研究院開發的動力外骨骼，訓練完全性脊髓損傷患者轉位及行走訓練的流程，期待可做為未來臨床應用相關技術時的參考。方法：本研究招募兩位完全性脊髓損傷患者，訓練項目為用動力外骨骼執行坐站轉位以及行走訓練。訓練由2位治療師執行8次的課程，共計8小時，內容包含使用動力外骨骼坐站轉位、跨步與行走。結果：經過8次的訓練課程後，兩位受試者皆可使用動力外骨骼獨立執行坐站轉位，並在治療師的最小協助至監督下連續行走6步（約5公尺）。受試者之自覺費力係數顯示使用動力外骨骼執行坐站轉位與行走較使用膝踝足矯具省力。兩位受試者中，以損傷位階較低者訓練的成果較佳。結論：完全性脊髓損傷患者可透過短期8次合計8小時的訓練，使用動力外骨骼完成獨立坐站轉位及行走短距離。使用動力外骨骼可使患者坐站轉位與行走跨步大為省力，但患者的損傷位階與軀幹穩定度會影響學習的進度與使用動力外骨骼的表現。日後若增加訓練的時數，可望再增進患者之行走距離與獨立性。

關鍵字

動力外骨骼；脊髓損傷；步態訓練

並列摘要

Background and Purpose: Powered exoskeleton improves the movement performance by providing mechanical support, and will play an important role in future gait training for people with spinal cord injury (SCI). This study documented the gait training protocol for people with complete SCI using the powered exoskeleton designed by the Industrial Technology Research Institute of Taiwan. Methods: We recruited two complete SCI patients in this report. The training was conducted by two physical therapists, which included 8 one-hour sessions practicing sit-to-stand/stand-to-sit and walking using the powered exoskeleton. Results: After 8 training sessions, all participants could successfully use the powered exoskeleton to sit-to-stand/stand-to-sit independently, and to walk 6 consecutive steps (around 5 meters) under therapists' supervision or minimal assistance. Participants reported lower perceived exertion while using the powered exoskeleton than using the knee-ankle-foot orthosis. In addition, the participant with lower injury level demonstrated better training outcome. Conclusion: Our 8 one-hour training program helped SCI patients to learn the powered exoskeleton for sit-to-stand/stand-to-sit and walking. The powered exoskeleton reduced the effort for sit-to-stand/stand-to-sit and walking, despite the performance could be affected by the level of injury. With more training hours, we expect the patients can walk with a long distance independently.

並列關鍵字

Powered exoskeleton ； Spinal cord injury ； Gait training

參考文獻

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脊髓損傷患者使用動力外骨骼行走之短期訓練計畫成效：前驅研究

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