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高强度机器人辅助手部训练对多发性硬化症患者上肢恢复及肌肉活动的影响:一项随机、对照、单盲试验

Effects of High-intensity Robot-assisted Hand Training on Upper Limb Recovery and Muscle Activity in Individuals With Multiple Sclerosis: A Randomized, Controlled, Single-Blinded Trial.

作者信息

Gandolfi Marialuisa, Valè Nicola, Dimitrova Eleonora Kirilova, Mazzoleni Stefano, Battini Elena, Benedetti Maria Donata, Gajofatto Alberto, Ferraro Francesco, Castelli Matteo, Camin Maruo, Filippetti Mirko, De Paoli Carola, Chemello Elena, Picelli Alessandro, Corradi Jessica, Waldner Andreas, Saltuari Leopold, Smania Nicola

机构信息

Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.

The BioRobotics Institute, Scuola Superiore Sant' Anna, Polo Sant' Anna Valdera, Pontedera, Italy.

出版信息

Front Neurol. 2018 Oct 24;9:905. doi: 10.3389/fneur.2018.00905. eCollection 2018.

Abstract

Integration of robotics and upper limb rehabilitation in people with multiple sclerosis (PwMS) has rarely been investigated. To compare the effects of robot-assisted hand training against non-robotic hand training on upper limb activity in PwMS. To compare the training effects on hand dexterity, muscle activity, and upper limb dysfunction as measured with the International Classification of Functioning. This single-blind, randomized, controlled trial involved 44 PwMS (Expanded Disability Status Scale:1.5-8) and hand dexterity deficits. The experimental group ( = 23) received robot-assisted hand training; the control group ( = 21) received non-robotic hand training. Training protocols lasted for 5 weeks (50 min/session, 2 sessions/week). Before (T0), after (T1), and at 1 month follow-up (T2), a blinded rater evaluated patients using a comprehensive test battery. Primary outcome: Action Research Arm Test. Secondary outcomes: Nine Holes Peg Test; Fugl-Meyer Assessment Scale-upper extremity section; Motricity Index; Motor Activity Log; Multiple Sclerosis (MS) Quality of Life-54; Life Habits assessment-general short form and surface electromyography. There were no significant between-group differences in primary and secondary outcomes. Electromyography showed relevant changes providing evidence increased activity in the extensor carpi at T1 and T2. The training effects on upper limb activity and function were comparable between the two groups. However, robot-assisted training demonstrated remarkable effects on upper limb use and muscle activity. https://clinicaltrials.gov NCT03561155.

摘要

机器人技术与多发性硬化症患者(PwMS)上肢康复的整合鲜有研究。比较机器人辅助手部训练与非机器人手部训练对PwMS上肢活动的影响。比较训练对用国际功能分类法测量的手部灵活性、肌肉活动和上肢功能障碍的影响。这项单盲、随机、对照试验纳入了44例PwMS患者(扩展残疾状态量表:1.5 - 8)且存在手部灵活性缺陷。实验组(n = 23)接受机器人辅助手部训练;对照组(n = 21)接受非机器人手部训练。训练方案持续5周(每次50分钟,每周2次)。在训练前(T0)、训练后(T1)以及1个月随访时(T2),由一位盲法评估者使用综合测试组对患者进行评估。主要结局指标:动作研究臂测试。次要结局指标:九孔插板测试;Fugl - Meyer评估量表上肢部分;运动指数;运动活动日志;多发性硬化症(MS)生活质量量表 - 54项;生活习惯评估 - 一般简表以及表面肌电图。在主要和次要结局指标方面,两组之间无显著差异。肌电图显示了相关变化,证明在T1和T2时腕伸肌的活动增加。两组在上肢活动和功能方面的训练效果相当。然而,机器人辅助训练在上肢使用和肌肉活动方面显示出显著效果。https://clinicaltrials.gov NCT03561155

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d124/6207593/eb8ff52f1892/fneur-09-00905-g0001.jpg

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