Hung Chung-Shan, Hsieh Yu-Wei, Wu Ching-Yi, Chen Yu-Ju, Lin Keh-Chung, Chen Chia-Ling, Yao Kaiping Grace, Liu Chien-Ting, Horng Yi-Shiung
1 Hualien Tzu Chi Hospital, Hualien.
2 Chang Gung University, Taoyuan.
OTJR (Thorofare N J). 2019 Apr;39(2):116-123. doi: 10.1177/1539449218825438. Epub 2019 Mar 5.
This study examined the treatment effects between unilateral hybrid therapy (UHT; unilateral robot-assisted therapy [RT] + modified constraint-induced movement therapy) and bilateral hybrid therapy (BHT; bilateral RT + bilateral arm training) compared with RT. Thirty patients with chronic stroke were randomized to UHT, BHT, or RT groups. Preliminary efficacy was assessed using the Fugl-Meyer Assessment (FMA), the Chedoke Arm and Hand Activity Inventory (CAHAI), and the goal attainment scaling (GAS). Possible adverse effects of abnormal muscle tone, pain, and fatigue were recorded. All groups showed large improvements in motor recovery and individual goals. Significant between-group differences were found on GAS favoring the hybrid groups but not on FMA and CAHAI. No adverse effects were reported. Hybrid therapies are safe and applicable interventions for chronic stroke and favorable for improving individual functional goals. Treatment effects on motor recovery and functional activity might be similar among the three groups.
本研究考察了单侧混合疗法（UHT；单侧机器人辅助疗法[RT]+改良的强制性使用运动疗法）和双侧混合疗法（BHT；双侧RT+双侧手臂训练）与RT相比的治疗效果。30例慢性卒中患者被随机分为UHT组、BHT组或RT组。使用Fugl-Meyer评估量表（FMA）、Chedoke手臂和手部活动量表（CAHAI）以及目标达成量表（GAS）评估初步疗效。记录肌张力异常、疼痛和疲劳等可能的不良反应。所有组在运动恢复和个体目标方面均有显著改善。在GAS上发现组间存在显著差异，支持混合疗法组，但在FMA和CAHAI上未发现。未报告不良反应。混合疗法是慢性卒中安全且适用的干预措施，有利于改善个体功能目标。三组在运动恢复和功能活动方面的治疗效果可能相似。
