Susanto Evan A, Tong Raymond Ky, Ockenfeld Corinna, Ho Newmen Sk
Interdisciplinary Division of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong, S.A.R., China.
Department of Electronic Engineering Division of Biomedical Engineering, The Chinese University of Hong Kong, Hong Kong, S.A.R., China.
J Neuroeng Rehabil. 2015 Apr 25;12:42. doi: 10.1186/s12984-015-0033-5.
While constraint-induced movement therapy (CIMT) is one of the most promising techniques for upper limb rehabilitation after stroke, it requires high residual function to start with. Robotic device, on the other hand, can provide intention-driven assistance and is proven capable to complement conventional therapy. However, with many robotic devices focus on more proximal joints like shoulder and elbow, recovery of hand and fingers functions have become a challenge. Here we propose the use of robotic device to assist hand and fingers functions training and we aim to evaluate the potential efficacy of intention-driven robot-assisted fingers training.
Participants (6 to 24 months post-stroke) were randomly assigned into two groups: robot-assisted (robot) and non-assisted (control) fingers training groups. Each participant underwent 20-session training. Action Research Arm Test (ARAT) was used as the primary outcome measure, while, Wolf Motor Function Test (WMFT) score, its functional tasks (WMFT-FT) sub-score, Fugl-Meyer Assessment (FMA), its shoulder and elbow (FMA-SE) sub-score, and finger individuation index (FII) served as secondary outcome measures.
Nineteen patients completed the 20-session training (
HKClinicalTrials.com HKCTR-1554); eighteen of them came back for a 6-month follow-up. Significant improvements (p < 0.05) were found in the clinical scores for both robot and control group after training. However, only robot group maintained the significant difference in the ARAT and FMA-SE six months after the training. The WMFT-FT score and time post-training improvements of robot group were significantly better than those of the control group.
This study showed the potential efficacy of robot-assisted fingers training for hand and fingers rehabilitation and its feasibility to facilitate early rehabilitation for a wider population of stroke survivors; and hence, can be used to complement CIMT.
虽然强制性运动疗法（CIMT）是中风后上肢康复最有前景的技术之一，但它需要患者一开始就具备较高的残余功能。另一方面，机器人设备可以提供意向驱动的辅助，并且已被证明能够补充传统疗法。然而，由于许多机器人设备专注于像肩部和肘部这样的近端关节，手部和手指功能的恢复已成为一项挑战。在此，我们提出使用机器人设备辅助手部和手指功能训练，并旨在评估意向驱动的机器人辅助手指训练的潜在疗效。
将参与者（中风后6至24个月）随机分为两组：机器人辅助（机器人）和非辅助（对照）手指训练组。每位参与者接受20节训练课程。动作研究臂测试（ARAT）用作主要结局指标，而Wolf运动功能测试（WMFT）评分、其功能任务（WMFT-FT）子评分、Fugl-Meyer评估（FMA）、其肩部和肘部（FMA-SE）子评分以及手指个体化指数（FII）用作次要结局指标。
19名患者完成了20节训练课程（试验注册号：HKClinicalTrials.com HKCTR-1554）；其中18人回来进行了6个月的随访。训练后，机器人组和对照组的临床评分均有显著改善（p < 0.05）。然而，只有机器人组在训练6个月后，ARAT和FMA-SE仍保持显著差异。机器人组的WMFT-FT评分及训练后时间改善情况显著优于对照组。
本研究显示了机器人辅助手指训练对手部和手指康复的潜在疗效及其促进更广泛中风幸存者群体早期康复的可行性；因此，可用于补充CIMT。
