ORIJINAL ARAŞTIRMA
Robot Yardımlı Yürüme Eğitimi Tedavisi Uygulanan Komplet ve İnkomplet Spinal Kord Yaralanmalı Hastaların Karşılaştırılması
Comparison of the Patients with Complete and Incomplete Spinal Cord Injury Administered Robotic-Assisted Gait Training Treatment
Received Date : 12 Jun 2019
Accepted Date : 03 Oct 2019
Available Online : 13 Nov 2019
Çiğdem ÇINARa, Kadriye ÖNEŞa, Mustafa Aziz YILDIRIMa, Gökşen GÖKŞENOĞLUa
aİstanbul Physical Medicine and Rehabilitation Training and Research Hospital, İstanbul, TURKEY
Doi: 10.31609/jpmrs.2019-70083 - Makale Dili: EN
J PMR Sci. 2020;23(1):12-9
ÖZET
Amaç: Çalışmanın amacı, subakut dönemde uygulanan robot
yardımlı yürüyüş eğitiminin, komplet ve inkomplet spinal kord yaralanmalı
hastalarda etkinliğini karşılaştırmaktı. Gereç ve Yöntemler:
Otuz dört hasta çalışmaya alındı. Birinci grup komplet, ikinci grup ise
inkomplet spinal kord yaralanmalı hastalardan oluşmaktaydı. Her iki
gruba da 10 seans robot yardımlı yürüme eğitimi ve konvansiyonel tedavi
uygulandı. Fonksiyonel ambulasyonu değerlendirmek için Spinal
Kord Yaralanması için Yürüyüş İndeksi (SKYYİ II) kullanıldı. Hastaların
fonksiyonel düzeyini belirlemek için Fonksiyonel Bağımsızlık Ölçütü
(FBÖ) kullanıldı. Yaşam kalitesi Kısa Form 36 (KF-36) ile
değerlendirildi. Bulgular: Her iki grupta da SKYYİ II, FBÖ skorlarına
göre anlamlı gelişim gözlendi (p<0.001). Her iki grup için başlangıç
skoru ve tedavi sonrası skor KF-36’nın tüm alt birimlerinde anlamlı bir
farklılık göstermedi (p>0.05). Sadece tedaviden sonra fiziksel aktivite
skoru, Grup 1 ve 2’deki başlangıç seviyesine göre anlamlı bir artışa sahipken
(p<0.05), tedaviden sonra puanların diğer skorlardaki başlangıç
puanlarına göre anlamlı bir değişiklik göstermedi (p>0.05). Sonuç:
Robot yardımlı yürüme eğitimi tedavisinin komplet ve inkomplet spinal
kord yaralanmalı hastaların fonksiyonel durumları, yürüme ve günlük
yaşam aktiviteleri üzerinde etkileri vardır. Ancak, subakut
dönemdeki komplet ve inkomplet spinal kord yaralanmalı hastalar arasında
aktivite açısından herhangi bir fark bulunamadı.
Anahtar Kelimeler: Omurilik yaralanması; yürüyüş; robotik rehabilitasyon; lokomat
ABSTRACT
Objective: The aim of the study was to compare the efficiency
of robotic-assisted gait training applied during the subacute
period for the patients with complete and incomplete spinal cord injury.
Material and Methods: Thirty-four patients were included in the
study. The patients were divided into two groups. The first group consisted
of the patients with complete spinal cord injury and the second
group comprised patients with incomplete spinal cord injury. Both
groups were provided 10 robotic treatment training sessions in addition
to conventional treatment. Walking Index Spinal Cord Injury II
(WISCI II) was used to evaluate functional ambulation. The functional
status of the patients was evaluated using Functional Independence
Measurement (FIM). The quality of life was evaluated using Short
Form 36 (SF-36). Results: Significant improvement was observed in
both groups according to WISCI II results and FIM scores (p<0.001).
For both groups, the baseline scores and after-treatment scores did not
exhibit a significant difference in all subscales of SF-36 (p>0.05). While
only after-treatment physical activity scores demonstrated a significant
increase compared to the baseline scores in Group 1 and 2 (p<0.05),
the after-treatment scores did not show a significant change compared
to the baseline scores in the other measurements of SF-36 subscales
(p>0.05). Conclusion: Robotic-assisted gait training treatment has effects
on functional status, gait and daily living activities for the patients
with complete and incomplete spinal cord injury. However, we were
unable to identify any difference in terms of activity between complete
and incomplete spinal cord injury in the subacute period.
Keywords: Spinal cord injury; gait; robotic rehabiliation; lokomat
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