Mazzoleni S, Puzzolante L, Zollo L, Dario P, Posteraro F
IEEE Trans Haptics. 2014 Apr-Jun;7(2):175-80. doi: 10.1109/TOH.2013.73.
The aim of this article is to propose a methodology for analyzing different recovery mechanisms in subacute and chronic patients through evaluation of biomechanical parameters. Twenty-five post-stroke subjects, eight subacute and seventeen chronic, participated in the study. A 2-DoF robotic system was used for upper limb training. Two clinical scales were used for assessment. Forces and velocities at the robot's end-effector during the execution of upper limb planar reaching movements were measured. Clinical outcome measures show a significant decrease in motor impairment after the treatment both in chronic and subacute patients (MSS-SE, p<0.001; FM, p<0.05). Movement velocity increases after the robot-aided treatment in both groups. Mean values of forces exerted by subacute patients are lower than those observed in chronic patients, both at the beginning and at the end of robotic treatment, as in the latter the pathological pattern is already structured. Our results demonstrate that the monitoring of the forces exerted on the end-effector during robot-aided treatment can identify the specific motor recovery mechanisms at different stages. If the pathological pattern is not yet structured, rehabilitative interventions should be addressed toward the use of motor re-learning procedures; on the other hand, if the force analysis shows a strong pathological pattern, mechanisms of compensation should be encouraged.
本文旨在提出一种通过评估生物力学参数来分析亚急性和慢性患者不同恢复机制的方法。25名中风后受试者参与了该研究，其中8名亚急性患者和17名慢性患者。使用一个双自由度机器人系统进行上肢训练。使用两种临床量表进行评估。测量了上肢平面伸展运动执行过程中机器人末端执行器的力和速度。临床结果显示，治疗后慢性和亚急性患者的运动障碍均显著降低（MSS-SE，p<0.001；FM，p<0.05）。两组在机器人辅助治疗后运动速度均有所提高。亚急性患者施加的力的平均值在机器人治疗开始和结束时均低于慢性患者，因为在慢性患者中病理模式已经形成。我们的结果表明，在机器人辅助治疗期间监测施加在末端执行器上的力可以识别不同阶段的特定运动恢复机制。如果病理模式尚未形成，康复干预应针对运动再学习程序的使用；另一方面，如果力分析显示出强烈的病理模式，则应鼓励补偿机制。
