Preliminary application of lower extremity exoskeletons in the rehabilitation of gait disorders after deep brain stimulation for Parkinson's disease
Objective To investigate the clinical effect and preliminary experience of programming and rehabilitation after deep brain stimulation for Parkinson's disease(PD)patients with gait disorder assisted by an exoskeleton system.Methods A total of 10 patients with PD with fluctuating gait disorder symptoms after bilateral deep brain stimulation(DBS)of the subthalamic nucleus(STN)in the Department of Functional Neurosurgery,the Affiliated Brain Hospital of Nanjing Medical University from June 2019 to June 2023.Before operation,Hoehn-Yahr grade 2.5 was reported in 2 cases,3.0 in 5 cases,and 4.0 in 3 cases.The exoskeleton system was used for force feedback training and gait posture correction training,and the gait data was monitored for DBS programming.The paired t-test was used to compare and analyze the swing phase of both lower limbs,stride length,velocity and cadence of both lower limbs before the first training and after the last training to evaluate the efficacy.Results All 10 patients were trained with the lower limb exoskeleton system to adjust the DBS programming parameters,and each round of training was 4 times with a total of 2-4 rounds.Compared with before the first training,the swing phase in both lower limbs increased after the last training[(27.57±2.39)％vs.(24.30±2.75)％on the left side;(27.38±2.96)％vs.(23.15±2.77)％on the right side],the stride length of both lower limbs increased(0.83±0.16 m vs.0.55±0.18 m on the left side;0.83±0.16 m vs.0.55±0.17 m on the right side),the velocity increased(0.73±0.18 m/s vs.0.46±0.14 m/s),and the difference was statistically significant(all P＜0.05),while the cadence was not significantly improved(106.80±15.50 steps/min vs.103.84±10.53 steps/min,P=0.559).Conclusion Preliminary studies have suggested that the application of lower limb exoskeleton system to assist postoperative programming and rehabilitation therapy of DBS in PD patients can improve the gait disorder of patients to a certain extent.
万方数据
维普
