Peter Orsolya, Tavaszi Ibolya, Toth Andras, Fazekas Gabor
National Institute for Medical Rehabilitation, Hungary.
Szent Janos Hospital, Hungary.
J Phys Ther Sci. 2017 May;29(5):854-858. doi: 10.1589/jpts.29.854. Epub 2017 May 16.
[Purpose] Investigation of the efficacy of robot-mediated therapy of the upper limb in patients with chronic stroke, in task-oriented training activities of daily living in real environment. [Subjects and Methods] 20 patients, each more than one year post-stroke (13-71 months) received 20 sessions of upper limb robot-mediated therapy. No other treatment was given. Each therapy session consisted of a passive motion and an active task therapy. During the active therapy, subjects exercised 5 activities of daily living. Assessments of the subjects were blind, and conducted one month prior to, at the start, at the end, and three months after the therapy course. The following outcome measures were recorded: Fugl-Meyer Scale-upper extremity subsection, Modified Ashworth Scale, Action Research Arm Test, Functional Independence Measure, Barthel Index. [Results] Significant improvements were observed between the start and the end of the therapy, except for Modified Ashworth Scale and Barthel Index. Results still held up at the follow-up visit three months later. [Conclusion] Practicing activities of daily living in real environment with robot-mediated physical therapy can improve the motor and functional ability of patients, even with relatively good initial functions, and even years post-stroke.
[目的] 研究在真实环境中进行面向任务的日常生活训练活动时,机器人辅助疗法对慢性中风患者上肢功能的疗效。[对象与方法] 20例中风后超过1年(13 - 71个月)的患者接受了20节上肢机器人辅助治疗课程。未给予其他治疗。每次治疗课程包括被动运动和主动任务治疗。在主动治疗期间,受试者进行5项日常生活活动。对受试者的评估是盲法进行的,在治疗课程开始前1个月、开始时、结束时以及结束后3个月进行。记录了以下结果指标:Fugl - Meyer量表上肢部分、改良Ashworth量表、动作研究上肢测试、功能独立性测量、Barthel指数。[结果] 除改良Ashworth量表和Barthel指数外,治疗开始和结束之间观察到显著改善。3个月后的随访时结果依然成立。[结论] 即使对于初始功能相对良好且中风多年后的患者,在真实环境中通过机器人辅助物理治疗进行日常生活活动练习也可以改善患者的运动和功能能力。