Lokomat机器人辅助步行训练对偏瘫儿童下肢运动功能的效果

doi:10.3969/j.issn.1006-9771.2025.06.012

Abstract

Abstract:

Objective To explore the effect of Lokomat robotic-assisted gait training on lower limb motor function in children with hemiplegia.

Methods From October, 2023 to January, 2025, a total of 52 children with hemiplegia admitted to Beijing Bo'ai Hospital were randomly divided into control group (n = 26) and observation group (n = 26). Both groups received conventional rehabilitation therapy, while the observation group additionally received Lokomat robotic-assisted gait training, for four weeks. Before and after intervention, the self-selected walking speed (SWS) and maximum walking speed (MWS) of 10-meter Walk Test, 6-minute walking distance (6MWD), Physiological Cost Index (PCI), as well as gait line length asymmetry ratio, single support line asymmetry ratio, stance phase asymmetry ratio and step length ratio were compared.

Results After intervention, SWS, MWS and 6MWD improved in both groups (|Z| > 2.910, P < 0.01), and were better in the the observation group than in the control group (|Z| > 2.069, P < 0.05); PCI significantly decreased in both groups (|Z| > 4.458, P < 0.001), and was lower in the observation group than in the control group (Z = -2.435, P < 0.05); the gait line length asymmetry ratio, single support line asymmetry ratio and stance phase asymmetry ratio improved in both groups (Z = 3.398, |t| > 2.211, P < 0.05), and were better in the observation group than in the control group (Z = 2.802, |t| > 2.107, P< 0.05).

Conclusion Lokomat robotic-assisted gait training can effectively improve walking speed and endurance in children with hemiplegia, reduce energy expenditure, enhance walking efficiency, and promote gait symmetry, thereby facilitating symmetrical gait patterns.

Key words: hemiplegia, children, robotic-assisted gait training, lower limb, motor function

CLC Number:

R742.3

ZHOU Tiantian, ZHANG Tong, ZHANG Qi, LIANG Yanhua, ZHANG Yanqing, YUE Qing, LI Sijia. Effect of Lokomat robotic-assisted gait training on lower limb motor function in children with hemiplegia[J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(6): 711-720.

Figures/Tables 7

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References 48

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组别	n	性别 (男/女)/n	年龄/岁	Brunnstorm分期 (Ⅲ/Ⅳ)/n
对照组	26	15/11	9.23±1.86	13/13
观察组	26	13/13	9.27±1.97	12/14
χ²/t值		0.310	0.072	0.077
P值		0.578	0.943	0.781

变量	组别	n	测试	M(Q_L, Q_U)	Z值	P值
SWS/m·s^-1	对照组	26	前测	0.91(0.57, 1.07)	-3.205	0.001
			后测	0.99(0.72, 1.11)
	观察组	26	前测	0.80(0.62, 1.05)	-4.461	< 0.001
			后测	1.08(0.90, 1.19)
	治疗前差值			0.05(-0.36, 0.29)	-0.293	0.770
	治疗后差值			-0.08(-0.42, -0.10)	-2.069	0.039
MWS/m·s^-1	对照组	26	前测	1.32(1.00, 1.46)	-2.910	0.004
			后测	1.36(1.13, 1.50)
	观察组	26	前测	1.22(1.07, 1.41)	-4.461	< 0.001
			后测	1.49(1.29, 1.64)
	治疗前差值			0.02(-0.35, 0.32)	-0.430	0.667
	治疗后差值			-0.22(-0.44, -0.11)	-2.069	0.039
6MWD/m	对照组	26	前测	397.51(294.50, 415.00)	-3.975	< 0.001
			后测	404.99(339.17, 432.27)
	观察组	26	前测	358.66(298.79, 410.00)	-4.457	< 0.001
			后测	442.56(366.24, 479.28)
	治疗前差值			5.33(-101.29, 110.04)	-0.805	0.421
	治疗后差值			-19.56(-119.93, 37.77)	-2.224	0.026

组别	n	测试	M(Q_L, Q_U)	Z值	P值
对照组	26	前测	1.07(0.86, 1.43)	-4.458	< 0.001
		后测	0.83(0.65, 1.16)
观察组	26	前测	1.00(0.86, 1.26)	-4.459	< 0.001
		后测	0.68(0.55, 0.85)
治疗前差值			0.08(-0.42, 0.45)	-0.595	0.552
治疗后差值			0.24(-0.08, 0.48)	-2.435	0.015

组别	n	测试	M(Q_L, Q_U)	Z值	P值
对照组	26	前测	0.73(0.66, 0.90)	-3.398	< 0.001
		后测	0.83(0.69, 0.92)
观察组	26	前测	0.84(0.66, 0.92)	-4.435	< 0.001
		后测	0.95(0.87, 1.00)
治疗前差值			0.02(-0.20, 0.09)	-0.586	0.558
治疗后差值			-0.07(-0.23, -0.08)	-2.802	0.005

组别	n	测试	$\bar{x} \pm s$	t值	P值
对照组	26	前测	0.38±0.19	-3.565	0.001
		后测	0.44±0.17
观察组	26	前测	0.40±0.18	-7.140	< 0.001
		后测	0.60±0.22
治疗前均值差			-0.02±0.22	0.375	0.709
治疗后均值差			-0.16±0.27	2.922	0.005

Effect of Lokomat robotic-assisted gait training on lower limb motor function in children with hemiplegia

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组别	n	测试	$\bar{x} \pm s$	t值	P值
对照组	26	前测	0.92±0.05	-2.211	0.036
		后测	0.94±0.04
观察组	26	前测	0.93±0.04	-4.847	< 0.001
		后测	0.97±0.04
治疗前均值差			-0.01±0.06	0.551	0.584
治疗后均值差			-0.02±0.05	2.107	0.040

组别	n	测试	M(Q_L, Q_U)	Z值	P值
对照组	26	前测	1.08(0.92, 1.19)	-0.229	0.819
		后测	1.09(0.96, 1.19)
观察组	26	前测	1.09(0.95, 1.15)	-0.903	0.367
		后测	1.04(0.95, 1.14)
治疗前差值			0.02(-0.19, 0.16)	-0.311	0.756
治疗后差值			0.07(-0.09, 0.17)	-0.706	0.480

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