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.

背景：吉兰-巴雷综合征（Guillain-Barre syndrome, GBS）是一种由感染后免疫反应引发的周围神经损伤。尽管吉兰-巴雷综合征的预后相对良好，但部分患者会出现行走障碍等严重功能缺损。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效果。本研究旨在评估末端执行器型机器人设备进行步态训练对吉兰-巴雷综合征患者的疗效。
方法：本研究为回顾性研究，纳入在住院期间接受过使用Morning Walk®设备的机器人辅助步态训练的吉兰-巴雷综合征确诊患者。在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）、功能性步行分级（Functional Ambulation Categories）、改良巴塞尔指数（Modified Barthel Index）评分、里弗赛德移动指数（Rivermead Mobility Index）以及2分钟步行试验。
结果：共计15例患者完成了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时长为3.9（±3.6）个月。与基线水平相比，所有与步态功能相关的结局指标在机器人辅助步态训练后均得到改善。
结论：机器人辅助步态训练可改善吉兰-巴雷综合征患者的行走能力，可作为吉兰-巴雷综合征患者步态功能康复的训练工具之一。