Human Motor Recovery Laboratory, Burke Neurological Institute, White Plains, NY, USA.
Division of Biostatistics and Epidemiology, Department of Healthcare Policy & Research, Weill Cornell Medicine, New York, NY, USA.
NeuroRehabilitation. 2020;46(3):287-297. doi: 10.3233/NRE-192993.
Neurological injuries cause persistent upper extremity motor deficits. Device-assisted therapy is an emerging trend in neuro-rehabilitation as it offers high intensity, repetitive practice in a standardized setting.
To investigate the effects of therapy duration and staff-participant configuration on device-assisted upper limb therapy outcomes in individuals with chronic paresis.
Forty-seven participants with chronic upper extremity weakness due to neurological injury were assigned to a therapy duration (30 or 60 min) and a staff-participant configuration (1-to-1 or 1-to-2). Therapy consisted of 3 sessions a week for 6 weeks using the Armeo®Spring device. Clinical assessments were performed at three timepoints (Pre, Post, and 3 month Follow up).
Improvements in upper limb impairment, measured by change in Fugl-Meyer score (FM), were observed following therapy in all groups. FM improvement was comparable between 30 and 60 min sessions, but participants in the 1-to-2 group had significantly greater improvement in FM from Pre-to-Post and from Pre-to-Follow up than the 1-to-1 group.
Device-assisted therapy can reduce upper limb impairment to a similar degree whether participants received 30 or 60 min per session. Our results suggest that delivering therapy in a 1-to-2 configuration is a feasible and more effective approach than traditional 1-to-1 staffing.
神经损伤会导致持续性的上肢运动功能障碍。设备辅助治疗是神经康复领域的一个新兴趋势，因为它可以在标准化的环境中提供高强度、重复性的练习。
探讨治疗时长和人员配置对慢性瘫痪患者使用设备辅助上肢治疗效果的影响。
47 名因神经损伤导致慢性上肢无力的参与者被分配到治疗时长（30 或 60 分钟）和人员配置（1 对 1 或 1 对 2）组。治疗包括每周 3 次，共 6 周，使用 Armeo®Spring 设备。在三个时间点（治疗前、治疗后和 3 个月随访）进行临床评估。
所有组在治疗后上肢损伤程度（以 Fugl-Meyer 评分（FM）的变化衡量）均有改善。30 分钟和 60 分钟治疗时长组的 FM 改善情况相当，但 1 对 2 组在 FM 从治疗前到治疗后和从治疗前到随访期间的改善程度明显大于 1 对 1 组。
参与者每次接受 30 或 60 分钟的治疗，设备辅助治疗都能在相似程度上降低上肢损伤程度。我们的结果表明，与传统的 1 对 1 配置相比，采用 1 对 2 配置进行治疗是一种更可行且更有效的方法。
