Background:Studies on robot-assisted gait training rehabilitation in multiple sclerosis have reported positive effects on mobility and quality of life. However, their effects on cognitive functions are difficult to determine because not all trials have included cognition assessments. Virtual reality-based training provides enhanced opportunity for stimulating cognitive abilities by repetitive practice, feedback information, and motivation for endurance practice. Objective:To compare the effects of innovative robot-assisted gait training combined with virtual reality versus standard robot-assisted gait training on information processing speed, sustained attention, working memory, and walking endurance in patients with multiple sclerosis. Methods:Seventeen outpatients were randomly assigned to receive robot-assisted gait training either with or without virtual reality. The robot assisted gait training + virtual reality group underwent end-effector system training engendered by virtual reality. The standard training group underwent end-effector system training. A blinded rater evaluated patients before and after treatment and at one month follow-up. The outcome measures were the Paced Auditory Serial Addition Test, Phonemic Fluency Test, Novel Task, Digit Symbol, Multiple Sclerosis Quality of Life-54, 2-Minutes Walk Test, 10-Meter Walking Test, Berg Balance Scale, gait analysis, and stabilometric assessment. Results:Between-group comparisons showed a significant change on the 2-Minutes Walk Test (p = 0.023) after treatment in the robot-assisted gait training + virtual reality group. Significant improvement were obtained also in executive functions (p = 0.012). Both gains were maintained at the 1-month follow-up evaluation (p = 0.012, p = 0.012) in the robot-assisted gait training + virtual reality group. Both group improved quality of life after treatment (Multiple Sclerosis Quality of Life-54: Mental Health p = 0.018, Physical Health p = 0.017). Conclusions:Both training lead to positive influenced on executive functions. However larger positive effects on gait ability were noted after robot-assisted gait training engendered by virtual reality with multiple sclerosis. Robot-assisted gait training provides a therapeutic alternative and motivational of traditional motor rehabilitation.

中文翻译：

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机器人辅助步态训练结合虚拟现实对多发性硬化患者运动和认知功能的影响：一项试点、单盲、随机对照试验。

背景：机器人辅助步态训练康复治疗多发性硬化症的研究报告了对活动能力和生活质量的积极影响。然而，它们对认知功能的影响很难确定，因为并非所有试验都包括认知评估。基于虚拟现实的训练通过重复练习、反馈信息和耐力练习的动机，为刺激认知能力提供了更好的机会。目的：比较创新机器人辅助步态训练结合虚拟现实与标准机器人辅助步态训练对多发性硬化患者信息处理速度、持续注意力、工作记忆和步行耐力的影响。方法：17 名门诊患者被随机分配接受有或没有虚拟现实的机器人辅助步态训练。机器人辅助步态训练+虚拟现实组进行了虚拟现实产生的末端执行器系统训练。标准培训组接受末端执行器系统培训。一位不知情的评分者在治疗前后以及一个月的随访中对患者进行了评估。结果测量是节奏听觉连续添加测试、音素流利测试、新任务、数字符号、多发性硬化症生活质量-54、2 分钟步行测试、10 米步行测试、伯格平衡量表、步态分析和稳定性测量评估。结果：在机器人辅助步态训练+虚拟现实组治疗后，组间比较显示2分钟步行测试（p = 0.023）有显着变化。执行功能也获得了显着改善（p = 0.012）。在机器人辅助步态训练 + 虚拟现实组的 1 个月随访评估（p = 0.012，p = 0.012）中，这两种增益均保持不变。两组治疗后的生活质量均有所改善（多发性硬化症生活质量-54：心理健康 p = 0.018，身体健康 p = 0.017）。结论：两种培训都对执行功能产生积极影响。然而，在多发性硬化症的虚拟现实产生的机器人辅助步态训练后，注意到对步态能力有更大的积极影响。机器人辅助步态训练提供了传统运动康复的治疗选择和动力。012, p = 0.012) 在机器人辅助步态训练 + 虚拟现实组中。两组治疗后的生活质量均有所改善（多发性硬化症生活质量-54：心理健康 p = 0.018，身体健康 p = 0.017）。结论：两种培训都对执行功能产生积极影响。然而，在多发性硬化症的虚拟现实产生的机器人辅助步态训练后，注意到对步态能力有更大的积极影响。机器人辅助步态训练提供了传统运动康复的治疗选择和动力。012, p = 0.012) 在机器人辅助步态训练 + 虚拟现实组中。两组治疗后的生活质量均有所改善（多发性硬化症生活质量-54：心理健康 p = 0.018，身体健康 p = 0.017）。结论：两种培训都对执行功能产生积极影响。然而，在多发性硬化症的虚拟现实产生的机器人辅助步态训练后，注意到对步态能力有更大的积极影响。机器人辅助步态训练提供了传统运动康复的治疗选择和动力。这两种培训都对执行功能产生了积极的影响。然而，在多发性硬化症的虚拟现实产生的机器人辅助步态训练后，注意到对步态能力有更大的积极影响。机器人辅助步态训练提供了传统运动康复的治疗选择和动力。这两种培训都对执行功能产生了积极的影响。然而，在多发性硬化症的虚拟现实产生的机器人辅助步态训练后，注意到对步态能力有更大的积极影响。机器人辅助步态训练提供了传统运动康复的治疗选择和动力。