可穿戴设备用于慢性脑卒中患者上肢康复的可行性和疗效：一项随机对照初步研究。
Feasibility and efficacy of wearable devices for upper limb rehabilitation in patients with chronic stroke: a randomized controlled pilot study.
机构信息
Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan.
School of Gerontology and Health Management, Taipei Medical University, Taipei, Taiwan.
出版信息
Eur J Phys Rehabil Med. 2018 Jun;54(3):388-396. doi: 10.23736/S1973-9087.17.04691-3. Epub 2017 Jun 19.
BACKGROUND
Wearable devices based on inertial measurement units through wireless sensor networks have many applications such as real-time motion monitoring and functional outcome assessment of stroke rehabilitation. However, additional investigations are warranted to validate their clinical value, particularly in detecting the synergy patterns of movements after stroke.
AIM
The aim of this study was to explore the feasibility and efficacy of wearable devices for upper limb rehabilitation in patients with chronic stroke and to compare the intervention effects (e.g., neurological recovery, active range of motion, and deviation angle) with those in a control group.
DESIGN
A single-blind, randomized-controlled pilot study.
SETTING
Rehabilitation ward.
METHODS
A total of 18 patients with chronic stroke were randomly distributed into a device group and control group. Both groups received conventional rehabilitation; nevertheless, the device group was additionally subjected to 15 daily sessions at least three times a week for 5 weeks. The outcome measures included the upper extremity subscores of the Fugl-Meyer assessment, active range of motion, and deviation angle. These measurements were performed pre- and post-treatment.
RESULTS
All five Fugl-Meyer assessment subscores improved in both the device and control groups after intervention; in particular, the "shoulder/elbow/forearm" subscore (P=0.02, 0.03) and "total score" (P=0.03, 0.03) substantially improved. The active range of motion of shoulder flexion and abduction substantially improved at pre-post treatment in both the device (P=0.02, 0.03) and control (P=0.02, 0.03) groups. The deviation angle of shoulder external rotation during shoulder abduction substantially improved in the device group (P=0.02), but not in the control group.
CONCLUSIONS
The designed wearable devices are practical and efficient for use in chronic patients with stroke.
CLINICAL REHABILITATION IMPACT
Wearable devices are expected to be useful for future internet-of-things rehabilitation clinical trials at home and in long-term care institutions.
背景
基于惯性测量单元的可穿戴设备通过无线传感器网络在实时运动监测和中风康复的功能评估等方面有许多应用。然而，需要进一步的研究来验证其临床价值，特别是在检测中风后运动的协同模式方面。
目的
本研究旨在探讨可穿戴设备在慢性中风患者上肢康复中的可行性和疗效，并与对照组比较干预效果（如神经恢复、主动活动范围和偏差角度）。
设计
单盲、随机对照的初步研究。
设置
康复病房。
方法
共 18 例慢性中风患者随机分为设备组和对照组。两组均接受常规康复治疗；然而，设备组每周至少进行 3 次，每次 15 次，共 5 周。评估指标包括 Fugl-Meyer 评估上肢子评分、主动活动范围和偏差角度。这些测量在治疗前后进行。
结果
两组干预后 Fugl-Meyer 评估的所有五个子评分均有改善，特别是“肩/肘/前臂”子评分（P=0.02，0.03）和“总分”（P=0.03，0.03）有显著改善。设备组（P=0.02，0.03）和对照组（P=0.02，0.03）肩前屈和外展的主动活动范围在治疗前后均有显著改善。在设备组中，肩外展时肩外旋的偏差角度有显著改善（P=0.02），但对照组无明显改善。
结论
设计的可穿戴设备在慢性中风患者中使用实用、高效。
临床康复影响
可穿戴设备有望在未来的家庭和长期护理机构的物联网康复临床试验中发挥作用。
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