Evaluación de la marcha en pacientes lesionados medulares en el Centro Internacional de Restauración Neurológica
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Jan 1, 2023
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Introducción: La lesión medular se puede considerar como cualquier alteración sobre la médula espinal que puede producir alteraciones en el movimiento, la sensibilidad o la función autónoma por debajo del nivel de lesión, entre las principales limitaciones se encuentra la perdida de la marcha, la cual en la mayoría de los casos representa la mayor prioridad de recuperación de los pacientes.
Objetivo: Evaluar la marcha en los pacientes lesionados medulares en el Centro Internacional de Restauración Neurológica.
Materiales y métodos: Para el estudio se seleccionó una muestra aleatoria de 30 pacientes de una población de 60 pacientes entre los años 2017- 2019, los cuales cumplieron con los criterios de inclusión y realizaron actividades de marcha evaluadas con la escala walking spinal cord injury versión II. Los datos obtenidos fueron procesados con el software estadístico SPSS 28.
Resultados: Los resultados obtenidos mostraron cambios estadísticamente significativos en la muestra analizada por sexo, por región afectada, por tiempo de rehabilitación de la marcha y de forma general.
Conclusiones: La evaluación de la marcha arrojo que las actividades de marcha realizadas en el Centro Internacional de restauración neurológica fueron efectivas y produjeron cambios significativos en la marcha de los pacientes.
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Echemendia del Valle, A., Sentmanat Belisón, A., Noa Pelier, B., & Gómez Pérez, R. (2023). Evaluación de la marcha en pacientes lesionados medulares en el Centro Internacional de Restauración Neurológica. Ciencia Y Deporte, 8(1), Pág(s): e4242. https://doi.org/10.34982/2223.1773.2023.V8.No1.001
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Abou, L., Malala, V., Yarnot, R., Alluri, A., & Rice, L. A. (2020). Effects of Virtual Reality Therapy on Gait and Balance Among Individuals With Spinal Cord Injury: A Systematic Review and Meta-analysis. Neurorehabil Neural Repair, 34(5), pp. 375-388. https://www.ncbi.nlm.nih.gov/pubmed/32270736
Aguirre, A., Perez, A., Quinzanos, J., Perez, R., & Barrera, A. (2019). Walking speed is not the best outcome to evaluate the effect of robotic assisted gait training in people with motor incomplete Spinal Cord Injury: A Systematic Review with meta-analysis. J Spinal Cord Med, 42(2), pp. 142-154. https://www.ncbi.nlm.nih.gov/pubmed/29065788
Alajam, R. A., Alqahtanti, A. S., Frederick, J., & Liu, W. (2020). The feasibility of an 8-Week walking training program using a novel assistive gait training device in individuals with spinal cord injury. Disabil Rehabil Assist Technol, pp. 1-10. https://doi.org/10.1080/17483107.2020.1805801
Alashram, A., Annino, G., & Padua, E. (2021). Robot-assisted gait training in individuals with spinal cord injury: A systematic review for the clinical effectiveness of Lokomat. J Clin Neurosci, 91, pp. 260-269. https://www.ncbi.nlm.nih.gov/pubmed/34373038
Atrice, M. B., Morrison, S. A., & McDowell, S. L. (2005). Traumatic spinal cord injury. In D. A. Umphred (Ed.), Neurological rehabilitation. (5 ed., pp. 605-657). Mosby Inc. https://www.nature.com/articles/nrdp201718
Barati, K., Kamyab, M., & Kamali, M. (2020). Comparison of the quality of life in individuals with spinal cord injury wearing either reciprocating gait orthosis or hip knee ankle foot orthosis: a cross-sectional study. Disabil Rehabil Assist Technol, pp. 1-5. https://doi.org/10.1080/17483107.2019.1685014
Behrman, A. L., & Hakerma, S. J. (2007). Physical rehabilitation as an agent for recovery after spinal cord injury. Phys Med Rehabil Clin N Am, 18, pp. 183-202. https://pubmed.ncbi.nlm.nih.gov/17543768/
Benito-Penalva, J., Edwards, D. J., Opisso, E., Cortes, M., Lopez-Blazquez, R., Murillo, N., Costa, U., Tormos, J. M., Vidal-Samso, J., Valls-Sole, J., European Multicenter Study about Human Spinal Cord Injury Study, G., & Medina, J. (2012). Gait training in human spinal cord injury using electromechanical systems: effect of device type and patient characteristics. Arch Phys Med Rehabil, 93(3), pp. 404-412. https://doi.org/10.1016/j.apmr.2011.08.028
Christodoulou, V. N., Varvarousis, D., Theodorou, A., Voulgaris, S., Beris, A., Doulgeri, S., Gelalis, I., & Ploumis, A. (2019). Rehabilitation of the multiple injured patient with spinal cord injury: A systematic review of the literature. Injury, 50(11), pp. 1847-1852. https://doi.org/10.1016/j.injury.2019.07.035
Ditunno-Jr, J. F., Ditunno , P. L., Scivoletto, G., Patrick, M., Dijkers, M., Barbeau, H., Burns, A. S., Marino, R. J., & Schmidt-Read, M. (2013). The Walking Index for Spinal Cord Injury (WISCI/WISCI II): nature, metric properties, use and misuse. Spinal Cord, 51, pp. 346-355. https://pubmed.ncbi.nlm.nih.gov/23459122/
Fulk, G., Schimtz, T. J., & Behrman, A. L. (2007). Traumatic spinal cord injury. In S. B. O´Sullivan (Ed.), Physical rehabilitation-assessment and treatment (pp. 937-998). F.A.Davis Company. https://www.worldcat.org/es/title/physical-rehabilitation-assessment-and-treatment/oclc/29913774
Gedde, M. H., Lilleberg, H. S., Assmus, J., Gilhus, N. E., & Rekand, T. (2019). Traumatic vs non-traumatic spinal cord injury: A comparison of primary rehabilitation outcomes and complications during hospitalization. J Spinal Cord Med, 42(6), pp. 695-701. https://doi.org/10.1080/10790268.2019.1598698
Kanazawa, A., Yoshikawa, K., Koseki, K., Takeuchi, R., & Mutsuzaki, H. (2019). A Consecutive 25-Week Program of Gait Training, Using the Alternating Hybrid Assistive Limb (HAL((R))) Robot and Conventional Training, and Its Effects on the Walking Ability of a Patient with Chronic Thoracic Spinal Cord Injury: A Single Case Reversal Design. Medicina (Kaunas), 55(11). https://doi.org/10.3390/medicina55110746
Mandigo, C. E., Kaiser, M., & Angevine, P. D. (2011). Lesión medular. In L. P. Rowland & T. A. Pedley (Eds.), Neurología de Merritt (12 ed., pp. 1031-1048). Lippincott Williams & Wilkins. (Reprinted from Not in File). https://books.google.com.cu/books/about/Neurolog%C3%ADa_de_Merritt.html?id=cJijcQAACAAJ&redir_esc=y
Manns, P. J., Hurd, C., & Yang, J. F. (2019). Perspectives of people with spinal cord injury learning to walk using a powered exoskeleton. J Neuroeng Rehabil, 16(1), p. 94. https://doi.org/10.1186/s12984-019-0565-1
Midik, M., Paker, N., Bugdayci, D., & Midik, A. C. (2020). Effects of robot-assisted gait training on lower extremity strength, functional independence, and walking function in men with incomplete traumatic spinal cord injury. Turk J Phys Med Rehabil, 66(1), pp. 54-59. https://doi.org/10.5606/tftrd.2020.3316
National Spinal Cord Injury Statistical Center. (2021, Marzo 2021). Facts and Figures at a Glance. Birmingham, AL: University of Alabama at Birmingham.https://medicine.umich.edu/sites/default/files/content/downloads/NSCISC%20SCI%20Facts%20and%20Figures%202021.pdf
Okawara, H., Sawada, T., Matsubayashi, K., Sugai, K., Tsuji, O., Nagoshi, N., Matsumoto, M., & Nakamura, M. (2020). Gait ability required to achieve therapeutic effect in gait and balance function with the voluntary driven exoskeleton in patients with chronic spinal cord injury: a clinical study. Spinal Cord, 58(5), .pp 520-527. https://doi.org/10.1038/s41393-019-0403-0
Richard-Denis, A., Benazet, D., Thompson, C., & Mac-Thiong, J. M. (2020). Determining priorities in functional rehabilitation related to quality of life one-year following a traumatic spinal cord injury. J Spinal Cord Med, 43(2), pp. 241-246. https://doi.org/10.1080/10790268.2018.1517138
Saha, S. (2020). Role of Virtual Reality in Balance Training in Patients with Spinal Cord Injury: A Prospective Comparative Pre-Post Study. Asian Spine J, 14(2), pp. 264-265. https://doi.org/10.31616/asj.2020.0051.r1
Staas, W. E., Formal, C., Freedman, M. K., Fried, G. W., & Schmidt, M. E. (1998). Spinal cord injury and spinal cord injury medicine. In J. A. Delisa & B. M. Gans (Eds.), Rehabilitation Medicine. Principles and practice (pp. 1259-1292). Lippincott-Raven Publisers. https://books.google.com.cu/books/about/Rehabilitation_Medicine.html?id=EdVsQgAACAAJ&utm_source=gb-gplus-shareRehabilitation
Stampacchia, G., Olivieri, M., Rustici, A., D'Avino, C., Gerini, A., & Mazzoleni, S. (2020). Gait rehabilitation in persons with spinal cord injury using innovative technologies: an observational study. Spinal Cord, 58(9), pp. 988-997. https://doi.org/10.1038/s41393-020-0454-2
Tan, K., Koyama, S., Sakurai, H., Teranishi, T., Kanada, Y., & Tanabe, S. (2021). Wearable robotic exoskeleton for gait reconstruction in patients with spinal cord injury: A literature review. J Orthop Translat, 28, pp. 55-64. https://www.ncbi.nlm.nih.gov/pubmed/33717982
Taylor, S. M., Cheung, E. O., Sun, R., Grote, V., Marchlewski, A., & Addington, E. L. (2019). Applications of complementary therapies during rehabilitation for individuals with traumatic Spinal Cord Injury: Findings from the SCIRehab Project. J Spinal Cord Med, 42(5), pp. 571-578. https://doi.org/10.1080/10790268.2018.1481693
Ullah, S., & Rathore, F. A. (2018). Neurological Recovery In Traumatic Spinal Cord Injury: Role Of Multidisciplinary Spinal Rehabilitation In Improving Outcomes. J Ayub Med Coll Abbottabad, 30(4), 620-621. https://www.ncbi.nlm.nih.gov/pubmed/30632352
Wu, C. H., Mao, H. F., Hu, J. S., Wang, T. Y., Tsai, Y. J., & Hsu, W. L. (2018). The effects of gait training using powered lower limb exoskeleton robot on individuals with complete spinal cord injury. J Neuroeng Rehabil, 15(1), pp. 14. https://doi.org/10.1186/s12984-018-0355-1
Aguirre, A., Perez, A., Quinzanos, J., Perez, R., & Barrera, A. (2019). Walking speed is not the best outcome to evaluate the effect of robotic assisted gait training in people with motor incomplete Spinal Cord Injury: A Systematic Review with meta-analysis. J Spinal Cord Med, 42(2), pp. 142-154. https://www.ncbi.nlm.nih.gov/pubmed/29065788
Alajam, R. A., Alqahtanti, A. S., Frederick, J., & Liu, W. (2020). The feasibility of an 8-Week walking training program using a novel assistive gait training device in individuals with spinal cord injury. Disabil Rehabil Assist Technol, pp. 1-10. https://doi.org/10.1080/17483107.2020.1805801
Alashram, A., Annino, G., & Padua, E. (2021). Robot-assisted gait training in individuals with spinal cord injury: A systematic review for the clinical effectiveness of Lokomat. J Clin Neurosci, 91, pp. 260-269. https://www.ncbi.nlm.nih.gov/pubmed/34373038
Atrice, M. B., Morrison, S. A., & McDowell, S. L. (2005). Traumatic spinal cord injury. In D. A. Umphred (Ed.), Neurological rehabilitation. (5 ed., pp. 605-657). Mosby Inc. https://www.nature.com/articles/nrdp201718
Barati, K., Kamyab, M., & Kamali, M. (2020). Comparison of the quality of life in individuals with spinal cord injury wearing either reciprocating gait orthosis or hip knee ankle foot orthosis: a cross-sectional study. Disabil Rehabil Assist Technol, pp. 1-5. https://doi.org/10.1080/17483107.2019.1685014
Behrman, A. L., & Hakerma, S. J. (2007). Physical rehabilitation as an agent for recovery after spinal cord injury. Phys Med Rehabil Clin N Am, 18, pp. 183-202. https://pubmed.ncbi.nlm.nih.gov/17543768/
Benito-Penalva, J., Edwards, D. J., Opisso, E., Cortes, M., Lopez-Blazquez, R., Murillo, N., Costa, U., Tormos, J. M., Vidal-Samso, J., Valls-Sole, J., European Multicenter Study about Human Spinal Cord Injury Study, G., & Medina, J. (2012). Gait training in human spinal cord injury using electromechanical systems: effect of device type and patient characteristics. Arch Phys Med Rehabil, 93(3), pp. 404-412. https://doi.org/10.1016/j.apmr.2011.08.028
Christodoulou, V. N., Varvarousis, D., Theodorou, A., Voulgaris, S., Beris, A., Doulgeri, S., Gelalis, I., & Ploumis, A. (2019). Rehabilitation of the multiple injured patient with spinal cord injury: A systematic review of the literature. Injury, 50(11), pp. 1847-1852. https://doi.org/10.1016/j.injury.2019.07.035
Ditunno-Jr, J. F., Ditunno , P. L., Scivoletto, G., Patrick, M., Dijkers, M., Barbeau, H., Burns, A. S., Marino, R. J., & Schmidt-Read, M. (2013). The Walking Index for Spinal Cord Injury (WISCI/WISCI II): nature, metric properties, use and misuse. Spinal Cord, 51, pp. 346-355. https://pubmed.ncbi.nlm.nih.gov/23459122/
Fulk, G., Schimtz, T. J., & Behrman, A. L. (2007). Traumatic spinal cord injury. In S. B. O´Sullivan (Ed.), Physical rehabilitation-assessment and treatment (pp. 937-998). F.A.Davis Company. https://www.worldcat.org/es/title/physical-rehabilitation-assessment-and-treatment/oclc/29913774
Gedde, M. H., Lilleberg, H. S., Assmus, J., Gilhus, N. E., & Rekand, T. (2019). Traumatic vs non-traumatic spinal cord injury: A comparison of primary rehabilitation outcomes and complications during hospitalization. J Spinal Cord Med, 42(6), pp. 695-701. https://doi.org/10.1080/10790268.2019.1598698
Kanazawa, A., Yoshikawa, K., Koseki, K., Takeuchi, R., & Mutsuzaki, H. (2019). A Consecutive 25-Week Program of Gait Training, Using the Alternating Hybrid Assistive Limb (HAL((R))) Robot and Conventional Training, and Its Effects on the Walking Ability of a Patient with Chronic Thoracic Spinal Cord Injury: A Single Case Reversal Design. Medicina (Kaunas), 55(11). https://doi.org/10.3390/medicina55110746
Mandigo, C. E., Kaiser, M., & Angevine, P. D. (2011). Lesión medular. In L. P. Rowland & T. A. Pedley (Eds.), Neurología de Merritt (12 ed., pp. 1031-1048). Lippincott Williams & Wilkins. (Reprinted from Not in File). https://books.google.com.cu/books/about/Neurolog%C3%ADa_de_Merritt.html?id=cJijcQAACAAJ&redir_esc=y
Manns, P. J., Hurd, C., & Yang, J. F. (2019). Perspectives of people with spinal cord injury learning to walk using a powered exoskeleton. J Neuroeng Rehabil, 16(1), p. 94. https://doi.org/10.1186/s12984-019-0565-1
Midik, M., Paker, N., Bugdayci, D., & Midik, A. C. (2020). Effects of robot-assisted gait training on lower extremity strength, functional independence, and walking function in men with incomplete traumatic spinal cord injury. Turk J Phys Med Rehabil, 66(1), pp. 54-59. https://doi.org/10.5606/tftrd.2020.3316
National Spinal Cord Injury Statistical Center. (2021, Marzo 2021). Facts and Figures at a Glance. Birmingham, AL: University of Alabama at Birmingham.https://medicine.umich.edu/sites/default/files/content/downloads/NSCISC%20SCI%20Facts%20and%20Figures%202021.pdf
Okawara, H., Sawada, T., Matsubayashi, K., Sugai, K., Tsuji, O., Nagoshi, N., Matsumoto, M., & Nakamura, M. (2020). Gait ability required to achieve therapeutic effect in gait and balance function with the voluntary driven exoskeleton in patients with chronic spinal cord injury: a clinical study. Spinal Cord, 58(5), .pp 520-527. https://doi.org/10.1038/s41393-019-0403-0
Richard-Denis, A., Benazet, D., Thompson, C., & Mac-Thiong, J. M. (2020). Determining priorities in functional rehabilitation related to quality of life one-year following a traumatic spinal cord injury. J Spinal Cord Med, 43(2), pp. 241-246. https://doi.org/10.1080/10790268.2018.1517138
Saha, S. (2020). Role of Virtual Reality in Balance Training in Patients with Spinal Cord Injury: A Prospective Comparative Pre-Post Study. Asian Spine J, 14(2), pp. 264-265. https://doi.org/10.31616/asj.2020.0051.r1
Staas, W. E., Formal, C., Freedman, M. K., Fried, G. W., & Schmidt, M. E. (1998). Spinal cord injury and spinal cord injury medicine. In J. A. Delisa & B. M. Gans (Eds.), Rehabilitation Medicine. Principles and practice (pp. 1259-1292). Lippincott-Raven Publisers. https://books.google.com.cu/books/about/Rehabilitation_Medicine.html?id=EdVsQgAACAAJ&utm_source=gb-gplus-shareRehabilitation
Stampacchia, G., Olivieri, M., Rustici, A., D'Avino, C., Gerini, A., & Mazzoleni, S. (2020). Gait rehabilitation in persons with spinal cord injury using innovative technologies: an observational study. Spinal Cord, 58(9), pp. 988-997. https://doi.org/10.1038/s41393-020-0454-2
Tan, K., Koyama, S., Sakurai, H., Teranishi, T., Kanada, Y., & Tanabe, S. (2021). Wearable robotic exoskeleton for gait reconstruction in patients with spinal cord injury: A literature review. J Orthop Translat, 28, pp. 55-64. https://www.ncbi.nlm.nih.gov/pubmed/33717982
Taylor, S. M., Cheung, E. O., Sun, R., Grote, V., Marchlewski, A., & Addington, E. L. (2019). Applications of complementary therapies during rehabilitation for individuals with traumatic Spinal Cord Injury: Findings from the SCIRehab Project. J Spinal Cord Med, 42(5), pp. 571-578. https://doi.org/10.1080/10790268.2018.1481693
Ullah, S., & Rathore, F. A. (2018). Neurological Recovery In Traumatic Spinal Cord Injury: Role Of Multidisciplinary Spinal Rehabilitation In Improving Outcomes. J Ayub Med Coll Abbottabad, 30(4), 620-621. https://www.ncbi.nlm.nih.gov/pubmed/30632352
Wu, C. H., Mao, H. F., Hu, J. S., Wang, T. Y., Tsai, Y. J., & Hsu, W. L. (2018). The effects of gait training using powered lower limb exoskeleton robot on individuals with complete spinal cord injury. J Neuroeng Rehabil, 15(1), pp. 14. https://doi.org/10.1186/s12984-018-0355-1