Lannin Natasha A, Cusick Anne, Hills Caroline, Kinnear Bianca, Vogel Karin, Matthews Kate, Bowring Greg
Occupational Therapy, School of Allied Health, College of Science, Health and Engineering, La Trobe University, Melbourne, Australia.
John Walsh Institute for Rehabilitation, Sydney Medical School (Northern), University of Sydney, Sydney, Australia.
Aust Occup Ther J. 2016 Dec;63(6):364-372. doi: 10.1111/1440-1630.12330. Epub 2016 Sep 19.
BACKGROUND/AIM: Assistive technologies have the potential to increase the amount of movement practice provided during inpatient stroke rehabilitation. The primary aim of this study was to investigate the feasibility of using the Saebo-Flex device in a subacute stroke setting to increase task-specific practice for people with little or no active hand movement. The secondary aim was to collect preliminary data comparing hand/upper limb function between a control group that received usual rehabilitation and an intervention group that used, in addition, the Saebo-Flex device.
Nine inpatients (mean three months (median six weeks) post-stroke) participated in this feasibility study conducted in an Australian rehabilitation setting, using a randomised pre-test and post-test design with concealed allocation and blinded outcome assessment. In addition to usual rehabilitation, the intervention group received eight weeks of daily motor training using the Saebo-Flex device. The control group received usual rehabilitation (task-specific motor training) only. Participants were assessed at baseline (pre-randomisation) and at the end of the eight-week study period. Feasibility was assessed with respect to ease of recruitment, application of the device, compliance with the treatment programme and safety. Secondary outcome measures included the Motor Assessment Scale (upper limb items), Box and Block Test, grip strength and the Stroke Impact Scale.
Recruitment to the study was very slow because of the low number of patients with little or no active hand movement. Otherwise, the study was feasible in terms of being able to apply the Saebo-Flex device and compliance with the treatment programme. There were no adverse events, and a greater amount of upper limb rehabilitation was provided to the intervention group. While there were trends in favour of the intervention group, particularly for dexterity, no between-group differences were seen for any of the secondary outcomes.
This pilot feasibility study showed that the use of assistive technology, specifically the Saebo-Flex device, could be successfully used in a sample of stroke patients with little or no active hand movement. However, recruitment to the trial was very slow. The use of the Saebo-Flex device had variable results on outcomes, with some positive trends seen in hand function, particularly dexterity.
背景/目的：辅助技术有可能增加住院中风康复期间的运动练习量。本研究的主要目的是调查在亚急性中风环境中使用Saebo - Flex设备的可行性，以增加手部几乎没有或没有主动运动的患者的特定任务练习。次要目的是收集初步数据，比较接受常规康复治疗的对照组与另外使用Saebo - Flex设备的干预组之间的手/上肢功能。
九名住院患者（中风后平均三个月（中位数六周））参与了在澳大利亚康复机构进行的这项可行性研究，采用随机前测和后测设计，分配过程隐蔽且结果评估设盲。除常规康复治疗外，干预组使用Saebo - Flex设备接受为期八周的每日运动训练。对照组仅接受常规康复治疗（特定任务运动训练）。在基线（随机分组前）和为期八周的研究期结束时对参与者进行评估。从招募的难易程度、设备的应用、对治疗方案的依从性和安全性方面评估可行性。次要结局指标包括运动评估量表（上肢项目）、箱块测试、握力和中风影响量表。
由于几乎没有或没有主动手部运动的患者数量较少，该研究的招募进展非常缓慢。除此之外，如果能够应用Saebo - Flex设备并保证对治疗方案的依从性，该研究是可行的。没有不良事件发生，并且干预组接受了更多的上肢康复治疗。虽然存在有利于干预组的趋势，特别是在灵活性方面，但在任何次要结局指标上均未观察到组间差异。
这项初步可行性研究表明，辅助技术，特别是Saebo - Flex设备，可以成功用于几乎没有或没有主动手部运动的中风患者样本。然而，该试验的招募进展非常缓慢。Saebo - Flex设备的使用在结局方面产生了不同的结果，在手功能方面有一些积极趋势，特别是在灵活性方面。
