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机器人疗法对慢性中风患者运动功能障碍及恢复的影响。

Effects of robotic therapy on motor impairment and recovery in chronic stroke.

作者信息

Fasoli Susan E, Krebs Hermano I, Stein Joel, Frontera Walter R, Hogan Neville

机构信息

Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139, USA.

出版信息

Arch Phys Med Rehabil. 2003 Apr;84(4):477-82. doi: 10.1053/apmr.2003.50110.

Abstract

OBJECTIVE

To examine whether robotic therapy can reduce motor impairment and enhance recovery of the hemiparetic arm in persons with chronic stroke.

DESIGN

Pre-posttest design.

SETTING

Rehabilitation hospital, outpatient care.

PARTICIPANTS

Volunteer sample of 20 persons diagnosed with a single, unilateral stroke within the past 1 to 5 years, with persistent hemiparesis.

INTERVENTIONS

Robotic therapy was provided 3 times weekly for 6 weeks. Subjects able to reach robot targets were randomly assigned to sensorimotor or progressive-resistive robotic therapy groups. Robotic therapy consisted of goal-directed, planar reaching tasks to exercise the hemiparetic shoulder and elbow.

MAIN OUTCOME MEASURES

The Modified Ashworth Scale, Fugl-Meyer test of upper-extremity function, Motor Status Scale (MSS) score, and Medical Research Council motor power score.

RESULTS

Evaluations by a single blinded therapist revealed statistically significant gains from admission to discharge (P<.05) on the Fugl-Meyer test, MSS score, and motor power score. Secondary analyses revealed group differences: the progressive-resistive therapy group experienced nonspecific improvements on wrist and hand MSS scores that were not observed in the sensorimotor group.

CONCLUSIONS

Robotic therapy may complement other treatment approaches by reducing motor impairment in persons with moderate to severe chronic impairments.

摘要

目的

探讨机器人疗法能否减轻慢性中风患者的运动障碍并促进偏瘫上肢的恢复。

设计

前后测试设计。

地点

康复医院,门诊护理。

参与者

20名志愿者样本,这些人在过去1至5年内被诊断为单次单侧中风,且存在持续性偏瘫。

干预措施

机器人疗法每周进行3次,共6周。能够触及机器人目标的受试者被随机分配到感觉运动或渐进性抗阻机器人治疗组。机器人疗法包括目标导向的平面伸展任务,以锻炼偏瘫的肩部和肘部。

主要观察指标

改良Ashworth量表、上肢功能Fugl-Meyer测试、运动状态量表(MSS)评分以及医学研究委员会运动力量评分。

结果

由单盲治疗师进行的评估显示,从入院到出院,Fugl-Meyer测试、MSS评分和运动力量评分有统计学意义的提高(P<.05)。二次分析显示了组间差异:渐进性抗阻治疗组在手腕和手部MSS评分上有非特异性改善,而感觉运动组未观察到这种情况。

结论

机器人疗法可能通过减轻中度至重度慢性损伤患者的运动障碍来补充其他治疗方法。

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