Huang Pai-Chuan, Hsieh Yu-Wei, Wang Chin-Man, Wu Ching-Yi, Huang Shu-Chun, Lin Keh-Chung
Pai-Chuan Huang, ScD, OTR/L, is Postdoctoral Fellow, Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan, and Healthy Aging Research Center at Chang Gung University, Taoyuan, Taiwan.
Yu-Wei Hsieh, PhD, is Assistant Professor, Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan, and Healthy Aging Research Center at Chang Gung University, Taoyuan, Taiwan.
Am J Occup Ther. 2014 May-Jun;68(3):325-33. doi: 10.5014/ajot.2014.010546.
A subgroup of patients benefiting most from robot-assisted therapy (RT) has not yet been described. We examined the predictors of improved outcomes after RT.
Sixty-six patients with stroke receiving RT were analyzed. The outcome measures were the Fugl-Meyer Assessment (FMA), Wolf Motor Function Test (WMFT), Motor Activity Log (MAL), and Stroke Impact Scale (SIS). The potential predictors were age, side of lesion, time since onset, Modified Ashworth Scale (MAS) scores, accelerometer data, Box and Block Test (BBT) scores, and kinematic parameters.
BBT scores were predictive of FMA (29%) and MAL (9%-15%) improvements. Reduced shoulder flexion synergy, as measured by less shoulder abduction during forward reach, and MAS-distal were predictive of WMFT-function improvements. MAS-distal was predictive of SIS-physical improvements. Demographic variables did not predict outcomes.
Manual dexterity was a valuable predictor of motor impairment and daily function after RT. Outcomes at different levels may have different predictors.
尚未明确最能从机器人辅助治疗（RT）中获益的患者亚组。我们研究了RT后改善预后的预测因素。
对66例接受RT的中风患者进行分析。结局指标包括Fugl-Meyer评估（FMA）、Wolf运动功能测试（WMFT）、运动活动日志（MAL）和中风影响量表（SIS）。潜在预测因素包括年龄、病变侧、发病时间、改良Ashworth量表（MAS）评分、加速度计数据、方块搭积木测试（BBT）评分和运动学参数。
BBT评分可预测FMA改善（29%）和MAL改善（9%-15%）。前伸时肩部外展减少所测量的肩部屈曲协同作用降低以及MAS-远端可预测WMFT-功能改善。MAS-远端可预测SIS-身体功能改善。人口统计学变量不能预测预后。
手部灵巧性是RT后运动障碍和日常功能的重要预测因素。不同水平的结局可能有不同的预测因素。
