Francisco Gerard E, Yozbatiran Nuray, Berliner Jeffrey, OʼMalley Marcia K, Pehlivan Ali Utku, Kadivar Zahra, Fitle Kyle, Boake Corwin
From the Department of Physical Medicine and Rehabilitation, University of Texas Health Science Center McGovern Medical School at Houston and the NeuroRecovery Research Center at TIRR Memorial Hermann, Houston, Texas (GEF, NY, JB, CB); Department of Mechanical Engineering, Rice University, Houston, Texas (MKO, AUP, ZK, KF); and The Institute for Rehabilitation and Research/Memorial Hermann, Houston, Texas (MKO).
Am J Phys Med Rehabil. 2017 Oct;96(10 Suppl 1):S171-S177. doi: 10.1097/PHM.0000000000000815.
The aim of the study was to demonstrate the feasibility, tolerability, and effectiveness of robotic-assisted arm training in incomplete chronic tetraplegia.
Pretest/posttest/follow-up was conducted. Ten individuals with chronic cervical spinal cord injury were enrolled. Participants performed single degree-of-freedom exercise of upper limbs at an intensity of 3-hr per session for 3 times a week for 4 wks with MAHI Exo-II. Arm and hand function tests (Jebsen-Taylor Hand Function Test, Action Research Arm Test), strength of upper limb (upper limb motor score, grip, and pinch strength), and independence in daily living activities (Spinal Cord Independence Measure II) were performed at baseline, end of training, and 6 mos later.
After 12 sessions of training, improvements in arm and hand functions were observed. Jebsen-Taylor Hand Function Test (0.14[0.04]-0.21[0.07] items/sec, P = 0.04), Action Research Arm Test (30.7[3.8]-34.3[4], P = 0.02), American Spinal Injury Association upper limb motor score (31.5[2.3]-34[2.3], P = 0.04) grip (9.7[3.8]-12[4.3] lb, P = 0.02), and pinch strength (4.5[1.1]-5.7[1.2] lb, P = 0.01) resulted in significant increases. Some gains were maintained at 6 mos. No change in Spinal Cord Independence Measure II scores and no adverse events were observed.
Results from this pilot study suggest that repetitive training of arm movements with MAHI Exo-II exoskeleton is safe and has potential to be an adjunct treatment modality in rehabilitation of persons with spinal cord injury with mild to moderate impaired arm functions.
本研究旨在证明机器人辅助手臂训练在不完全性慢性四肢瘫中的可行性、耐受性和有效性。
进行了前测/后测/随访。招募了10名慢性颈脊髓损伤患者。参与者使用MAHI Exo-II以每次3小时的强度进行上肢单自由度运动，每周3次，共4周。在基线、训练结束时和6个月后进行手臂和手部功能测试（杰布森-泰勒手部功能测试、动作研究手臂测试）、上肢力量（上肢运动评分、握力和捏力）以及日常生活活动独立性（脊髓独立性测量II）。
经过12次训练后，观察到手臂和手部功能有所改善。杰布森-泰勒手部功能测试（0.14[0.04]-0.21[0.07]项/秒，P = 0.04）、动作研究手臂测试（30.7[3.8]-34.3[4]，P = 0.02）、美国脊髓损伤协会上肢运动评分（31.5[2.3]-34[2.3]，P = 0.04）、握力（9.7[3.8]-12[4.3]磅，P = 0.02）和捏力（4.5[1.1]-5.7[1.2]磅，P = 0.01）均显著增加。一些改善在6个月时得以维持。脊髓独立性测量II评分无变化，未观察到不良事件。
这项初步研究的结果表明，使用MAHI Exo-II外骨骼对手臂运动进行重复训练是安全的，并且有可能成为轻度至中度手臂功能受损的脊髓损伤患者康复的辅助治疗方式。
