Vpliv robotsko podprte vadbe hoje na ravnotežje in hojo pri pacientih po možganski kapi - pregled literature : diplomsko delo

Merdanović, Jasmina (author), Kovačič, Tine (mentor), Brezovar, Tjaž (comentor), Hlebš, Sonja (reviewer)

Uvod: Možganska kap predstavlja drugi vodeči vzrok smrti v svetu. Preživeli po možganski kapi imajo najpogosteje težave s hojo in z ravnotežjem. Obstaja več načinov vadbe hoje in ravnotežja. Ena najbolj raziskovanih oblik vadbe hoje je robotsko podprta vadba hoje (RAGT). Uporablja se za rehabilitacijo spodnjih udov in najpogosteje v kombinaciji s standardno obliko fizioterapije. V Sloveniji se za takšno vrsto vadbe uporablja robotska naprava Lokomat. Ni še povsem jasno, ali ima prednost pred standardno fizioterapijo. Namen: Namen diplomskega dela je bil s pomočjo pregleda literature proučiti učinkovitost robotsko podprte vadbe hoje na parametre hoje in na ravnotežje pri pacientih po MK. Metode dela: Literatura je bila iskana v podatkovni bazi PubMed. Uporabljena je bila naslednja kombinacija besed: robot assisted gait training AND stroke. Uporabljeni so bili naslednji vključitveni kriteriji: raziskave, dostopne v polnem besedilu, randomizirane nadzirane raziskave, raziskave, objavljene med letoma 2018 in 2023, raziskave v angleškem jeziku. Rezultati: V pregled literature je bilo vključenih sedem randomiziranih kontroliranih raziskav. Vse so preučevale vpliv RAGT na hojo in ravnotežje pri pacientih po možganski kapi. V raziskavah so bili vključeni preiskovanci obeh spolov v različnih obdobjih po možganski kapi, z različno vrsto možganske kapi, različno prizadeto stranjo in različnim funkcijskim stanjem. RAGT se je izvajala samostojno ali v kombinaciji s standardno fizioterapijo. V vseh raziskavah je prišlo do statistično pomembnega izboljšanja hoje in ravnotežja, vendar v nekaterih raziskavah ni bilo statistično pomembne razlike med RAGT in vadbo hoje brez uporabe robotskih naprav. Razprava in zaključek: Ugotovljeno je, da je RAGT v kombinaciji s standardno fizioterapevtsko obravnavo učinkovitejša v primerjavi s fizioterapevtsko obravnavo brez uporabe robotskih naprav v vseh obdobjih po možganski kapi. Največ koristi od RAGT imajo pacienti v akutni fazi in tisti, ki niso bili zmožni samostojne hoje. V prihodnosti so potrebne bolj kakovostne randomizirane nadzorovane raziskave z večjim vzorcem in daljšim časovnim spremljanjem po končani obravnavi v različnih obdobjih po možganski kapi, da se lahko z gotovostjo poroča o vplivih RAGT.

• Language: Slovenian
• Keywords: diplomska dela, fizioterapija, možganska kap, robotsko podprta vadba hoje, hoja, ravnotežje, pacienti po možganski kapi
• Work type: Bachelor thesis/paper
• Typology: 2.11 - Undergraduate Thesis
• Organization: ZF - Faculty of Health Sciences
• Place of publishing: Ljubljana
• Publisher: [J. Merdanović]
• Year: 2024
• Number of pages: 45 str.
• PID: 20.500.12556/RUL-163854
• UDC: 615.8
• COBISS.SI-ID: 211356163
• Publication date in RUL: 13.10.2024

Secondary language

• Language: English
• Title: Effect of robot-assisted gait training on balance and gait in stroke patients - literature review : diploma work

Abstract

Introduction: Stroke is the second leading cause of death in the world. Stroke survivors most often have problems with their gait and balance. There are several ways to train gait and balance. One of the most investigated types of gait training is robotic-assisted gait training (RAGT). It is used for lower limb rehabilitation and is usually combined with a conventional physiotherapy. In Slovenia, the Lokomat system is used for this type of training. It is not yet clear whether it is superior to conventional physiotherapy. Purpose: The purpose of this thesis was to determine, based on a literature review, how robotic assisted gait training affects balance and gait in stroke patients. Methods: The literature was searched in the PubMed database. The following combination of words was used: robot assisted gait training AND stroke. The following inclusion criteria were used: studies available in full text, randomised controlled trials, studies published between 2018 and 2023, studies in English. Results: Seven randomised controlled trials were included in the literature review. All of them investigated the effect of RAGT on gait and balance in post stroke patients. The studies included subjects of both genders at different periods after stroke, different types of stroke, different affected side and different functional status. RAGT was performed alone or in combination with conventional physiotherapy. In all studies there was a statistically significant improvement in gait and balance, but in some studies there was no statistically significant difference between RAGT and gait training without the use of robotic devices. Discussion and conclusion: It has been found that RAGT combined with conventional physiotherapy treatment is more effective compared to physiotherapy treatment without the use of robotic devices in all post-stroke periods. Patients in the acute phase and those who were unable to walk independently benefit the most from RAGT. In the future, better quality randomised controlled trials with larger sample sizes and longer post-treatment follow-up at different time points after stroke are needed to report with certainty on the effects of RAGT.

• Keywords: diploma theses, physiotherapy, stroke, robot-assisted gait training, gait, balance, post-stroke patients