School of Engineering, University of Guelph, Guelph, N1G 2W1, Ontario, Canada.
J Neuroeng Rehabil. 2011 Aug 26;8:50. doi: 10.1186/1743-0003-8-50.
Physical rehabilitation is an area where robotics could contribute significantly to improved motor return for individuals following a stroke. This paper presents the results of a preliminary randomized controlled trial (RCT) of a robot system used in the rehabilitation of the paretic arm following a stroke.
The study's objectives were to explore the efficacy of this new type of robotic therapy as compared to standard physiotherapy treatment in treating the post-stroke arm; to evaluate client satisfaction with the proposed robotic system; and to provide data for sample size calculations for a proposed larger multicenter RCT. Twenty clients admitted to an inpatient stroke rehabilitation unit were randomly allocated to one of two groups, an experimental (robotic arm therapy) group or a control group (conventional therapy). An occupational therapist blinded to patient allocation administered two reliable measures, the Chedoke Arm and Hand Activity Inventory (CAHAI-7) and the Chedoke McMaster Stroke Assessment of the Arm and Hand (CMSA) at admission and discharge. For both groups, at admission, the CMSA motor impairment stage of the affected arm was between 1 and 3.
Data were compared to determine the effectiveness of robot-assisted versus conventional therapy treatments. At the functional level, both groups performed well, with improvement in scores on the CAHAI-7 showing clinical and statistical significance. The CAHAI-7 (range7-49) is a measure of motor performance using functional items. Individuals in the robotic therapy group, on average, improved by 62% (95% CI: 26% to 107%) while those in the conventional therapy group changed by 30% (95% CI: 4% to 61%). Although performance on this measure is influenced by hand recovery, our results showed that both groups had similar stages of motor impairment in the hand. Furthermore, the degree of shoulder pain, as measured by the CMSA pain inventory scale, did not worsen for either group over the course of treatment.
Our findings indicated that robotic arm therapy alone, without additional physical therapy interventions tailored to the paretic arm, was as effective as standard physiotherapy treatment for all responses and more effective than conventional treatment for the CMSA Arm (p = 0.04) and Hand (p = 0.04). At the functional level, both groups performed equally well.
在康复领域，机器人可以在提高中风患者的运动功能恢复方面发挥重要作用。本文介绍了一项针对中风后瘫痪手臂康复的机器人系统的初步随机对照试验（RCT）的结果。
该研究的目的是探索这种新型机器人治疗与标准物理治疗相比在治疗中风后手臂方面的疗效；评估患者对拟议机器人系统的满意度；并为拟议的更大规模多中心 RCT 提供样本量计算数据。20 名入住住院脑卒中康复病房的患者被随机分配到实验组（机器人手臂治疗组）或对照组（常规治疗组）。一位对患者分配情况不知情的作业治疗师在入院和出院时使用两种可靠的测量工具，即 Chedoke 手臂和手活动量表（CAHAI-7）和 Chedoke McMaster 脑卒中评估手臂和手（CMSA），对患者进行评估。对于两组患者，在入院时，受影响手臂的 CMSA 运动损伤阶段为 1 至 3 级。
对数据进行比较以确定机器人辅助治疗与常规治疗的效果。在功能水平上，两组患者的表现都很好，CAHAI-7 评分的改善显示出临床和统计学意义。CAHAI-7（范围 7-49）是一种使用功能项目衡量运动表现的测量工具。机器人治疗组的患者平均提高了 62%（95%置信区间：26%至 107%），而常规治疗组的患者则提高了 30%（95%置信区间：4%至 61%）。虽然该测量工具的表现受到手部恢复的影响，但我们的结果表明，两组患者手部的运动损伤阶段相似。此外，在治疗过程中，两组患者的肩部疼痛程度（通过 CMSA 疼痛量表测量）均未恶化。
我们的发现表明，仅使用机器人手臂治疗，而不进行针对瘫痪手臂的额外物理治疗干预，与标准物理治疗对所有反应一样有效，并且对 CMSA 手臂（p=0.04）和手（p=0.04）的疗效优于常规治疗。在功能水平上，两组患者的表现同样出色。
