Department of Rehabilitation and Movement Sciences, University of Medicine and Dentistry of New Jersey, Newark, NJ, USA.
J Neurol Phys Ther. 2012 Jun;36(2):79-86. doi: 10.1097/NPT.0b013e3182566f3f.
A majority of studies examining repetitive task practice facilitated by robots for the treatment of upper extremity paresis utilize standardized protocols applied to large groups. Others utilize interventions tailored to patients but do not describe the clinical decision-making process utilized to develop and modify interventions. This case study describes a robot-based intervention customized to match the goals and clinical presentation of person with upper extremity hemiparesis secondary to stroke.
The patient, P.M., was an 85-year-old man with left hemiparesis secondary to an intracerebral hemorrhage 5 years prior to examination. Outcomes were measured before and after a 1-month period of home therapy and after a 1-month robotic intervention. The intervention was designed to address specific impairments identified during his physical therapy examination. When necessary, activities were modified on the basis of response to the first week of treatment.
P.M. trained in 12 sessions, using six virtually simulated activities. Modifications to original configurations of these activities resulted in performance improvements in five of these activities. P.M. demonstrated a 35-second improvement in Jebsen Test of Hand Function time and a 44-second improvement in Wolf Motor Function Test time subsequent to the robotic training intervention. Reaching kinematics, 24-hour activity measurement, and scores on the Hand and Activities of Daily Living scales of the Stroke Impact Scale all improved as well.
A customized program of robotically facilitated rehabilitation was associated with short-term improvements in several measurements of upper extremity function in a patient with chronic hemiparesis.
大多数研究通过机器人进行重复性任务练习，以治疗上肢瘫痪，这些研究使用标准化方案对大样本进行研究。还有一些研究使用针对患者的干预措施，但没有描述用于制定和修改干预措施的临床决策过程。本病例研究描述了一种基于机器人的干预措施，该措施根据中风后上肢偏瘫患者的目标和临床表现进行了定制。
患者 P.M. 是一名 85 岁男性，5 年前因颅内出血导致左侧偏瘫。在接受 1 个月家庭治疗和 1 个月机器人干预前后，分别测量了结果。该干预措施旨在解决其物理治疗检查中发现的特定障碍。如有必要，根据第一周的治疗反应对活动进行修改。
P.M. 进行了 12 次训练，使用了 6 种虚拟模拟活动。对这些活动的原始配置进行修改，使其中 5 种活动的表现得到了改善。在接受机器人训练干预后，P.M.的 Jebsen 手部功能测试时间缩短了 35 秒，Wolf 运动功能测试时间缩短了 44 秒。手部和日常生活活动量表的运动评分以及日常生活活动量表的得分也有所提高。
针对慢性偏瘫患者，一项定制的机器人辅助康复计划与上肢功能的多项测量的短期改善相关。
