The effect of an end-effector type of robot-assisted gait training on patients with Guillain-Barré syndrome

Background: Guillain-Barre syndrome (GBS) is a peripheral nerve injury caused by a post-infectious immune response. Although the prognosis of GBS is relatively good, some patients have severe impairments such as walking disabilities. Robot-assisted gait training (RAGT) is used to improve gait function in various neurologic disorders; however, no studies have reported its effectiveness in GBS patients. We aimed to evaluate the effect of gait training using an end-effector type robotic device on GBS patients.

Methods: This was a retrospective study of patients diagnosed with GBS who received RAGT using Morning Walk® at the inpatient department. The main outcome measures evaluated before and after RAGT were: Medical Research Council scale, Functional Ambulation Categories, Modified Barthel Index score, Rivermead Mobility Index, and 2-minute walk test.

Results: In total, 15 patients underwent RAGT 24 times. The mean age was 55.7 (±15.3) years and the average time from onset was 3.9 (±3.6) months. When compared to the baseline, all outcome measures associated with gait function were improved after RAGT.

Conclusions: RAGT can improve walking ability in GBS patients. RAGT can be considered as one of the gait training tools to recover gait function in GBS patients.

Methods
We retrospectively analysed patients with GBS who treated robotic assisted gait training from April 2016 to January 2020.

背景：吉兰-巴雷综合征（Guillain-Barre syndrome, GBS）是一类由感染后免疫应答介导的周围神经损伤。尽管该病整体预后相对良好，但部分患者仍会出现步行障碍等严重功能障碍。机器人辅助步态训练（Robot-assisted gait training, RAGT）已被用于改善多种神经系统疾病患者的步态功能，但目前尚无研究报道其在吉兰-巴雷综合征患者中的应用有效性。本研究旨在评估末端执行器型机器人设备辅助的步态训练对吉兰-巴雷综合征患者的治疗效果。
方法：本研究为回顾性研究，研究对象为在住院病房接受Morning Walk®设备辅助机器人步态训练的吉兰-巴雷综合征确诊患者。本研究于机器人辅助步态训练前后评估的主要结局指标包括：医学研究委员会肌力评分（Medical Research Council scale）、功能性步行分类量表（Functional Ambulation Categories）、改良Barthel指数评分（Modified Barthel Index score）、Rivermead活动指数（Rivermead Mobility Index）以及2分钟步行试验（2-minute walk test）。
结果：本研究共纳入15例患者，累计完成24次机器人辅助步态训练。患者平均年龄为55.7（±15.3）岁，从发病至接受训练的平均间隔时长为3.9（±3.6）个月。与基线水平相比，机器人辅助步态训练后所有与步态功能相关的结局指标均得到改善。
结论：机器人辅助步态训练可改善吉兰-巴雷综合征患者的步行能力，可作为吉兰-巴雷综合征患者步态功能康复的训练手段之一。
方法：我们对2016年4月至2020年1月期间接受机器人辅助步态训练的吉兰-巴雷综合征患者开展了回顾性分析。