Fasoli Susan E, Fragala-Pinkham Maria, Hughes Richard, Hogan Neville, Krebs Hermano Igo, Stein Joel
Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Am J Phys Med Rehabil. 2008 Nov;87(11):929-36. doi: 10.1097/PHM.0b013e31818a6aa4.
Our aim was to examine the feasibility and effects of robotic therapy for children with cerebral palsy and upper limb hemiplegia.
A single group within-subjects design was used. Twelve children aged 5-12 yrs with moderate to severe motor impairments participated in 1-hr robotic therapy sessions, 2 times per week for 8 wks. During each session, children used the paretic arm to perform 640 repetitive, goal-directed planar reaching movements, with robotic assistance as needed. Primary outcomes were the Quality of Upper Extremity Skills Test (QUEST) and the Fugl-Meyer Assessment upper limb subtest. Secondary outcomes were the Modified Ashworth Scale, peak isometric strength of shoulder and elbow muscles, and parent questionnaire scores.
We found significant gains in total QUEST and Fugl-Meyer Assessment scores at discharge and follow-up and in isometric strength of elbow extensors at discharge. The parent questionnaire showed significant improvements in "how much" and "how well" children used the paretic arm during daily functional tasks at home.
Robotic therapy can provide new opportunities for improving upper limb coordination and function in children with moderate to severe impairments due to cerebral palsy or stroke.
我们的目的是研究机器人疗法对患有脑瘫和上肢偏瘫儿童的可行性及效果。
采用单组被试内设计。12名年龄在5至12岁、有中度至重度运动障碍的儿童参加了为期8周、每周2次、每次1小时的机器人疗法课程。在每次课程中,儿童使用患侧手臂进行640次重复性、有目标导向的平面够物动作,并根据需要接受机器人辅助。主要结局指标为上肢技能测试质量(QUEST)和Fugl-Meyer评估上肢子测试。次要结局指标为改良Ashworth量表、肩部和肘部肌肉的等长肌力峰值以及家长问卷评分。
我们发现,出院时和随访时QUEST和Fugl-Meyer评估总分以及出院时肘伸肌等长肌力均有显著提高。家长问卷显示,在孩子在家中进行日常功能任务时,患侧手臂的“使用程度”和“使用效果”有显著改善。
机器人疗法可为改善因脑瘫或中风导致中度至重度损伤儿童的上肢协调性和功能提供新机会。