Dehem Stéphanie, Gilliaux Maxime, Lejeune Thierry, Detrembleur Christine, Galinski Daniel, Sapin Julien, Vanderwegen Martin, Stoquart Gaëtan
Institut de Recherche Expérimentale et Clinique, Université catholique de Louvain, 1200 Brussels, Belgium.
J Rehabil Med. 2017 Jul 7;49(7):565-571. doi: 10.2340/16501977-2248.
To assess the capacity of the robotic device REAplan to measure overall upper limb peak resistance force, as a reflection of upper limb spasticity.
Twelve patients with chronic stroke presenting upper limb spasticity were recruited to the study. Patients underwent musculocutaneous motor nerve block to reduce the spasticity of elbow flexor muscles. Each patient was assessed before and after the motor nerve block. Overall the REAplan measured upper limb resistance force. The robot passively mobilized the patient's upper limb at various velocities (10, 20, 30, 40 and 50 cm/s) in a back-and-forth trajectory (30 cm). The peak resistance force was analysed for each forward movement. Ten movements were performed and averaged at each velocity condition.
The overall upper limb resistance force increased proportionally to the mobilization velocity (p< 0.001). Resistance force decreased after the motor nerve block at 40 and 50 cm/s (p < 0.05). Overall upper limb resistance force results showed excellent correlation with the Modified Ashworth Scale for elbow flexor muscles, for each velocity condition equal or higher than 30 cm/s (ρ >0.6).
This study proposes a new, valid, reliable and sensitive protocol to quantify upper limb resistance force using the REAplan, as a reflection of upper limb spasticity.
评估机器人设备REAplan测量上肢总峰值阻力的能力，以此反映上肢痉挛情况。
招募12例存在上肢痉挛的慢性卒中患者参与本研究。患者接受肌皮运动神经阻滞以减轻肘屈肌的痉挛。在运动神经阻滞前后对每位患者进行评估。REAplan测量上肢总阻力。机器人以不同速度（10、20、30、40和50厘米/秒）在前后轨迹（30厘米）中被动移动患者上肢。分析每次向前移动时的峰值阻力。在每个速度条件下进行10次移动并求平均值。
上肢总阻力与移动速度成正比增加（p<0.001）。在40和50厘米/秒的速度下，运动神经阻滞后阻力降低（p<0.05）。在每个等于或高于30厘米/秒的速度条件下，上肢总阻力结果与肘屈肌改良Ashworth量表显示出极好的相关性（ρ>0.6）。
本研究提出了一种新的、有效、可靠且敏感的方案，使用REAplan量化上肢阻力，以反映上肢痉挛情况。
