Duret Christophe, Hutin Emilie, Lehenaff Laurent, Gracies Jean-Michel
CRF Les Trois Soleils, Médecine Physique et de Réadaptation, Unité de Rééducation Neurologique, Boissise-Le-Roi (77), France.
Analyse et Restauration du Mouvement, Groupe Hospitalier Henri Mondor, Rééducation Neurolocomotrice, AP-HP, Créteil (94), France.
Restor Neurol Neurosci. 2015;33(1):57-65. doi: 10.3233/RNN-140418.
Upper limb robot-assisted rehabilitation is a highly intensive therapy, mainly recommended after stroke. Whether robotic therapy is suitable for subacute patients with severe impairments including cognitive disorders is unknown. This retrospective study explored factors impacting on motor performance achieved in a 16-session robotic training combined with standard rehabilitation.
Seventeen subacute inpatients (age 53 ± 18; 49 ± 26 days post-stroke) were assessed at baseline using upper extremity motor impairments scales, Functional Independence Measure, aphasia and neglect scores. Number of movements and robotic assistance were compared between Session 2 (S2), 8 (8) and 16 (S16), Motricity Index between pre and post-treatment. Correlation analyses explored predictors of motor performance.
Overall, number of movements and Motricity Index increased significantly while robot-assistance decreased. The mean number of movements per session correlated positively with baseline motor capacities but not with age, aphasia and neglect. However, the increase in Motricity index correlated negatively with baseline Motricity index and the increase in the number of movements correlated negatively with the number of movements at S2.
High intensity robot-assisted training may be associated with motor improvement in subacute hemiparesis. More severely impaired patients may derive greater benefit from robot-assisted training; age, aphasia and neglect do not represent exclusion criteria.
上肢机器人辅助康复是一种高强度治疗方法，主要推荐用于中风后患者。机器人治疗是否适用于包括认知障碍在内的严重功能障碍的亚急性患者尚不清楚。这项回顾性研究探讨了在16节机器人训练结合标准康复治疗中影响运动表现的因素。
17名亚急性住院患者（年龄53±18岁；中风后49±26天）在基线时使用上肢运动障碍量表、功能独立性测量、失语和忽视评分进行评估。比较第2节（S2）、第8节（S8）和第16节（S16）的运动次数和机器人辅助情况，以及治疗前后的运动能力指数。相关性分析探讨了运动表现的预测因素。
总体而言，运动次数和运动能力指数显著增加，而机器人辅助减少。每节的平均运动次数与基线运动能力呈正相关，但与年龄、失语和忽视无关。然而，运动能力指数的增加与基线运动能力指数呈负相关，运动次数的增加与S2时的运动次数呈负相关。
高强度机器人辅助训练可能与亚急性偏瘫患者的运动改善有关。功能障碍更严重的患者可能从机器人辅助训练中获益更大；年龄、失语和忽视并不代表排除标准。
