上肢机器人疗法治疗亚急性期脑卒中偏瘫的疗效：一项探索性随机试验。
Efficacy of Upper Extremity Robotic Therapy in Subacute Poststroke Hemiplegia: An Exploratory Randomized Trial.
机构信息
From the Department of Occupational Therapy, Kitasato University, Kanagawa, Japan (K.T.); Department of Rehabilitation Medicine, Hyogo College of Medicine, Hyogo, Japan (K.D.); Department of Rehabilitation, Kansai Rehabilitation Hospital, Osaka, Japan (T.S.); Department of Rehabilitation, Tokeidai Memorial Hospital, Hokkaido, Japan (M.T.); Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, Japan (Y.O.); Department of Neurology, Nagasaki Kita Hospital, Nagasaki, Japan (M.S.); Department of Neurology, Hakujuji Hospital, Fukuoka, Japan (K.I.); Department of Rehabilitation, Kitakyushu Yahatahigashi Hospital, Fukuoka, Japan (B.H.); Department of Rehabilitation, The Hospital of Hyogo College of Medicine, Hyogo, Japan (T.T.); and Moji Medical Center, Fukuoka, Japan (K.H.).
出版信息
Stroke. 2016 May;47(5):1385-8. doi: 10.1161/STROKEAHA.115.012520. Epub 2016 Mar 22.
BACKGROUND AND PURPOSE
Our aim was to study the efficacy of robotic therapy as an adjuvant to standard therapy during poststroke rehabilitation.
METHODS
Prospective, open, blinded end point, randomized, multicenter exploratory clinical trial in Japan of 60 individuals with mild to moderate hemiplegia 4 to 8 weeks post stroke randomized to receive standard therapy plus 40 minutes of either robotic or self-guided therapy for 6 weeks (7 days/week). Upper extremity impairment before and after intervention was measured using the Fugl-Meyer assessment, Wolf Motor Function Test, and Motor Activity Log.
RESULTS
Robotic therapy significantly improved Fugl-Meyer assessment flexor synergy (2.1±2.7 versus -0.1±2.4; P<0.01) and proximal upper extremity (4.8±5.0 versus 1.9±5.5; P<0.05) compared with self-guided therapy. No significant changes in Wolf Motor Function Test or Motor Activity Log were observed. Robotic therapy also significantly improved Fugl-Meyer assessment proximal upper extremity among low-functioning patients (baseline Fugl-Meyer assessment score <30) and among patients with Wolf Motor Function Test ≥120 at baseline compared with self-guided therapy (P<0.05 for both).
CONCLUSIONS
Robotic therapy as an adjuvant to standard rehabilitation may improve upper extremity recovery in moderately impaired poststroke patients. Results of this exploratory study should be interpreted with caution.
CLINICAL TRIAL REGISTRATION
URL: http://www.umin.ac.jp/. Unique identifier: UMIN000001619.
背景与目的
我们旨在研究机器人治疗作为中风后康复标准治疗的辅助手段的疗效。
方法
在日本进行的一项前瞻性、开放性、盲终点、随机、多中心探索性临床试验，纳入 60 例轻至中度偏瘫患者，中风后 4 至 8 周，随机分为标准治疗加 40 分钟机器人或自我指导治疗组，共 6 周（每周 7 天）。干预前后采用 Fugl-Meyer 评估、Wolf 运动功能测试和运动活动日志评估上肢损伤。
结果
机器人治疗组与自我指导治疗组相比，Fugl-Meyer 评估屈肌协同（2.1±2.7 与-0.1±2.4；P<0.01）和近端上肢（4.8±5.0 与 1.9±5.5；P<0.05）显著改善。Wolf 运动功能测试或运动活动日志无显著变化。机器人治疗组还显著改善了低功能患者（基线 Fugl-Meyer 评估评分<30）和基线 Wolf 运动功能测试≥120 的患者的近端上肢 Fugl-Meyer 评估（两者均 P<0.05）。
结论
机器人治疗作为标准康复的辅助手段，可能改善中度受损中风后患者的上肢恢复。该探索性研究的结果应谨慎解释。
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