Improving the lower limb functioning and walking ability of stroke survivors with robot-assisted dual-task training
10.3760/cma.j.issn.0254-1424.2024.02.003
- VernacularTitle:基于下肢康复机器人的双任务训练对脑卒中患者下肢运动及步行能力的影响
- Author:
Erkang XIE
1
;
Yangyang CONG
;
Yuyuan WANG
;
Yan HUA
;
Weining WANG
;
Yulong BAI
Author Information
1. 复旦大学附属华山医院康复医学科，上海 200040
- Keywords:
Stroke;
Robotics;
Dual-task training;
Functional near-infrared spectroscopy;
Walking ability
- From:
Chinese Journal of Physical Medicine and Rehabilitation
2024;46(2):112-117
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the effects of dual task training assisted by a lower limb rehabilitation robot on lower extremity mobility and the walking ability of stroke survivors.Methods:Sixty-one stroke survivors were randomly divided into a control group and an experimental group with 30 in the control group and 31 in the experimental group. In addition to routine exercise training and physical therapy, both groups were given cognitive-motor dual task training 5 times a week for 3 weeks. But only in the experimental group was the dual task training assisted by a lower limb rehabilitation robot. Both groups′ lower limb motor function, walking ability, cognition, balance and ability in the activities of daily living were evaluated before and after the experiment using the Fugl-Meyer lower extremity assessment (FMA-LE), functional ambulation categories (FAC), the digital span test (DST), the Berg Balance Scale (BBS) and the Modified Barthel Index (MBI). Additionally, 6 survivors of a right hemisphere stroke from the experimental group received cognitive-motor dual task training both with and without the robotic assistance alternately. Near-infrared functional brain imaging was applied before and after the intervention, and the functional network connectivity of the resting brains was analyzed.Results:After the intervention the average FMA-LE, FAC, BBS and MBI scores had improved in both groups, with the improvement in the experimental group significantly better than in the control group on average. In terms of cognition there was no significant difference in the DST forward and backward assessment results between the two groups. The analysis of brain network functional connectivity showed that the intensity of functional connectivity between the left prefrontal cortex (PFC) and the left premotor cortex and supplementary motor cortex (PMC/SMA) increased significantly more, on average, after training assisted by the robot.Conclusion:Dual task training with the assistance of a lower limb rehabilitation robot can effectively improve the lower limb motor function, walking, balance and ability in the activities of daily living of stroke survivors. Enhanced functional connection of the PFC and the PMC/SMA in the healthy hemisphere induced by the robot may be the cause.
