Hung Chung-Shan, Hsieh Yu-Wei, Wu Ching-Yi, Lin Yi-Ting, Lin Keh-Chung, Chen Chia-Ling
School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan, Republic of China(∗).
Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine and Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan, Republic of China(†).
PM R. 2016 Aug;8(8):721-9. doi: 10.1016/j.pmrj.2016.01.008. Epub 2016 Jan 22.
Robot-assisted therapy (RT) is a promising intervention for stroke rehabilitation. RT hybridized with therapist-mediated therapy (eg, RT plus task-specific or impairment-oriented training) may possibly yield functionally relevant improvements. A comparative study of the different combination regimens is needed.
To investigate the efficacy of RT combined with task-specific training or impairment-oriented training on motor function and quality of life in patients with chronic stroke.
A single-blind, randomized comparative efficacy study.
Two medical centers in Taiwan.
Twenty-one subjects with chronic stroke.
Participants were recruited and randomized into 1 of 2 groups: (1) RT combined with task-specific (RTT) training (enrolled, n = 11; completed, n = 11) or (2) RT combined with impairment-oriented (RTI) training (enrolled, n = 10; completed, n = 9). Participants received 20 intervention sessions (90-100 min/d, 5 d/wk for 4 weeks).
The Fugl-Meyer Motor Assessment Upper Extremity subscale, Stroke Impact Scale, Action Research Arm Test, and Medical Research Council Scale were administered at baseline, posttreatment, and at 3-month follow-up. Two-way repeated-measures analysis of variance was used to investigate the treatment effects.
The improvements of the RTT group in motor function measured by the Fugl-Meyer Motor Assessment Upper Extremity subscale and quality of life assessed by the Stroke Impact Scale were significantly superior to the RTI group after the interventions. The improvements of the RTT group were maintained for 3 months. Both groups demonstrated significant within-group improvements in motor function, muscle power, and quality of life.
RTT may be a more compelling approach to enhance motor function and quality of life for a long-term period than RTI. The combination of RT with task-specific training and with impairment-oriented training had similar benefits on upper limb motor function and muscle strength immediately after the interventions.
机器人辅助治疗（RT）是一种很有前景的中风康复干预方法。将RT与治疗师介导的治疗相结合（例如，RT加特定任务或针对损伤的训练）可能会在功能上产生相关改善。需要对不同的联合方案进行比较研究。
探讨RT联合特定任务训练或针对损伤的训练对慢性中风患者运动功能和生活质量的疗效。
单盲随机对照疗效研究。
台湾的两个医疗中心。
21名慢性中风患者。
招募参与者并随机分为两组：（1）RT联合特定任务（RTT）训练（入组，n = 11；完成，n = 11）或（2）RT联合针对损伤的（RTI）训练（入组，n = 10；完成，n = 9）。参与者接受20次干预治疗（每天90 - 100分钟，每周5天，共4周）。
在基线、治疗后和3个月随访时进行Fugl - Meyer运动评估上肢分量表、中风影响量表、动作研究臂测试和医学研究委员会量表评估。采用双向重复测量方差分析来研究治疗效果。
干预后，通过Fugl - Meyer运动评估上肢分量表测量的RTT组运动功能改善以及通过中风影响量表评估的生活质量改善均显著优于RTI组。RTT组的改善维持了3个月。两组在运动功能、肌肉力量和生活质量方面均显示出组内显著改善。
与RTI相比，RTT可能是一种更具吸引力的长期增强运动功能和生活质量的方法。干预后立即进行，RT与特定任务训练以及与针对损伤的训练相结合对上肢运动功能和肌肉力量具有相似的益处。
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