自平衡机器人外骨骼帮助 ALS 患者练习行走

Pilot study suggests hands-free exoskeleton is safe, feasible aid

试点研究表明，免手持外骨骼是一种安全、可行的辅助工具

A self-balancing, hands-free robotic exoskeleton designed for people with severe gait impairment was safe and well tolerated in a small pilot study of amyotrophic lateral sclerosis (ALS) patients who could still walk .

一项针对仍能行走的肌萎缩侧索硬化症（ALS）患者开展的小型试点研究显示，一款专为步态严重受损者设计的自平衡免手持机器人外骨骼安全且耐受性良好。

While six weeks of walking practice with the Atalante exoskeleton did not significantly slow declines in walking ability or other clinical measures, participants reported feeling more mobile, standing more upright, and having a greater sense of accomplishment after using the device.

尽管使用 Atalante 外骨骼进行六周行走训练并未显著减缓行走能力或其他临床指标的下降，但参与者表示，使用该设备后，他们感觉活动能力有所增强、站姿更加挺直，并获得了更强的成就感。

“An intensive, hands-free gait-training program using the self-balancing Atalante exoskeleton is feasible, clinically safe, and highly valued by ambulant people with ALS,” the researchers wrote, while adding that future studies are needed “to test whether it preserves function.”

研究人员写道：“使用自平衡 Atalante 外骨骼开展高强度免手持步态训练，对仍能行走的 ALS 患者而言可行、临床安全，并获得了高度认可。”他们同时补充说，未来还需开展研究，“以检验其能否维持功能”。

The study, “ Safety, feasibility and preliminary effects of Atalante exoskeleton-assisted gait training in amyotrophic lateral sclerosis: a prospective ABA pilot study ,” was published in the Journal of NeuroEngineering and Rehabilitation .

这项题为《Atalante 外骨骼辅助步态训练用于肌萎缩侧索硬化症的安全性、可行性及初步效果：一项前瞻性 ABA 试点研究》的研究发表于 Journal of NeuroEngineering and Rehabilitation。

For people living with ALS , a progressive neurodegenerative condition that gradually weakens muscles, walking often becomes slower, more tiring, and less stable over time. As walking becomes more difficult and the risk of falls increases, many people naturally become less active. But reduced physical activity can itself accelerate the loss of mobility, independence, and quality of life, making maintaining mobility for as long as possible an important part of care.

ALS 是一种进行性神经退行性疾病，会逐渐导致肌肉无力。对于 ALS 患者而言，随着时间推移，行走往往会变得更缓慢、更费力且更不稳定。随着行走愈发困难且跌倒风险增加，许多人会自然而然地减少活动。然而，身体活动减少本身也会加速活动能力、独立性和生活质量的下降，因此，尽可能长久地维持活动能力是照护工作的重要组成部分。

Conventional walking becomes increasingly difficult as weakness and balance problems worsen, posing a challenge to mobility and independence. Robotic exoskeletons help overcome that challenge by supporting people while they practice walking. However, most exoskeletons require users to rely on crutches or walkers for balance. That limits their usefulness in ALS, in which arm strength also declines over time.

随着肌无力和平衡问题加重，常规行走会变得越来越困难，对活动能力和独立性构成挑战。机器人外骨骼通过在患者练习行走时提供支撑，帮助克服这一挑战。然而，大多数外骨骼都要求使用者依靠拐杖或助行器保持平衡。这限制了它们在 ALS 中的实用性，因为 ALS 患者的手臂力量也会随时间推移而下降。

The Atalante exoskeleton, developed by Wandercraft , takes a different approach. It balances itself while providing adjustable levels of robotic assistance to support the user’s weight. This allows people to stand and practice different walking tasks while remaining actively involved in each step.

由 Wandercraft 开发的 Atalante 外骨骼采用了不同的方法。它能够自行保持平衡，同时提供可调节级别的机器人助力，以支撑使用者的体重。这使人们能够站立并练习不同的行走任务，同时主动参与每一步。

Previous studies in other neurological disorders suggested this type of hands-free training can be delivered safely, but it had not been tested in people with ALS.

此前针对其他神经系统疾病的研究表明，这类免手持训练可以安全实施，但尚未在 ALS 患者中进行过测试。

Researchers in France conducted a pilot study (NCT06199284) involving 10 adults. The 18-week study consisted of an initial six weeks of usual care, six weeks of exoskeleton-assisted gait training in addition to usual care, and a six-week follow-up period after the training ended. Assessments were performed every three weeks throughout the study.

法国研究人员开展了一项涉及 10 名成年人的试点研究（NCT06199284）。这项为期 18 周的研究包括最初六周的常规照护、在常规照护基础上增加六周外骨骼辅助步态训练，以及训练结束后的六周随访期。整个研究期间每三周进行一次评估。

The main goal was to determine whether hands-free, exoskeleton-assisted gait training was safe and feasible, while also exploring its effects on walking ability, muscle strength, balance, fatigue, breathing function, quality of life, and disease progression.

研究的主要目标是确定免手持外骨骼辅助步态训练是否安全、可行，同时探索其对行走能力、肌肉力量、平衡能力、疲劳、呼吸功能、生活质量和疾病进展的影响。

Participants, most of whom were men (80%), had a mean age of 55.8 and had been living with ALS for a median of 19.5 months. Seven (70%) relied on some form of walking assistance.

参与者大多为男性（80%），平均年龄为 55.8 岁，患 ALS 的中位时间为 19.5 个月。7 人（70%）依赖某种形式的行走辅助。

All 10 participants completed the program, with 98% of scheduled training sessions completed. Overall, the exoskeleton was well tolerated, and no serious safety issues occurred during training. Researchers recorded 11 adverse events, but only one — a minor pinch to a participant’s forearm — was considered device-related, and no one stopped training because of side effects.

全部 10 名参与者均完成了该项目，预定训练课程的完成率为 98%。总体而言，外骨骼耐受性良好，训练期间未出现严重的安全问题。研究人员记录了 11 起不良事件，但只有 1 起——一名参与者的前臂受到轻微夹伤——被认为与设备有关，且无人因副作用而停止训练。

As the sessions progressed, participants gradually took more steps while requiring shorter rest breaks, even as the level of robotic assistance remained unchanged. Pain levels stayed low throughout the program, while fatigue increased slightly immediately after training, an expected effect of exercise.

随着训练课程推进，即使机器人助力水平保持不变，参与者也逐渐能够走更多步，同时所需的休息时间更短。整个项目期间疼痛程度始终较低，而训练后即刻的疲劳感略有增加，这是运动的预期效应。

When researchers evaluated walking ability, muscle strength, balance, breathing function, fatigue, quality of life, and disease progression, they did not find statistically significant improvements compared with periods of usual care alone. However, several measures followed a pattern suggesting that functional decline may have slowed during the six weeks of exoskeleton training.

研究人员评估行走能力、肌肉力量、平衡能力、呼吸功能、疲劳、生活质量和疾病进展后发现，与仅接受常规照护的阶段相比，这些指标并未出现具有统计学意义的改善。不过，多项指标呈现出一种趋势，提示在六周外骨骼训练期间，功能衰退可能有所减缓。

“The absence of statistically significant improvements should not be interpreted as absence of effect,” the researchers wrote, noting that the findings likely reflect the combination of ALS’s rapid progression, the small number of participants, and the relatively short study period.

研究人员写道：“没有出现具有统计学意义的改善，不应被解读为没有效果。”他们指出，这些结果可能反映了 ALS 进展迅速、参与者人数较少以及研究周期相对较短等因素的共同影响。

Participants also reported positive experiences with the exoskeleton. Most (80%) said they felt less immobile and had a greater sense of accomplishment after the sessions, while 70% felt their posture had improved. Six participants (60%) also reported improved walking stability, reduced muscle stiffness, and better overall well-being.

参与者也报告了使用外骨骼的积极体验。大多数人（80%）表示，训练后他们感觉不再那么难以活动，并获得了更强的成就感；70% 的人认为自己的姿势有所改善。6 名参与者（60%）还报告称，行走稳定性有所提高、肌肉僵硬有所减轻，整体幸福感也有所改善。

“In ALS, where the goal may be as much to preserve function as to improve it, our findings position Atalante as a credible platform to restore safe upright mobility,” the researchers concluded, adding that larger studies are needed to determine whether the technology can help slow mobility loss over time.

研究人员总结道：“对于 ALS 而言，维持功能与改善功能可能同样重要；我们的研究结果表明，Atalante 是一个有望恢复安全直立活动能力的可靠平台。”他们补充说，还需开展更大规模的研究，以确定该技术能否帮助减缓活动能力随时间推移而下降。