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接受传统或机器人康复治疗的亚急性中风患者上肢运动恢复的时间进程。初步报告。

Time course of the upper limb motor recovery in subacute stroke patients undergoing conventional or robotic rehabilitation. A preliminary report.

作者信息

Germanotta M, Cruciani A, Galli C, Cattaneo D, Spedicato A, Aprile I

机构信息

IRCCS Fondazione Don Carlo Gnocchi, ONLUS, Florence, Italy.

IRCCS Fondazione Don Carlo Gnocchi, ONLUS, Milan, Italy.

出版信息

J Biol Regul Homeost Agents. 2020 Sep-Oct;34(5 Suppl. 3):201-208. Technology in Medicine.

Abstract

Upper limb recovery is a complex process and a strong challenge in the rehabilitation of patients after stroke. Several studies have been conducted to compare the efficacy of conventional and robotic rehabilitation to restore the upper limb motor impairment following a stroke. However, the evolution of the upper limb motor ability during an intervention, as well as the time point when the patient stops improving (the so call plateau), are rarely measured, and never compared between the two approaches. These latter aspects are very important considering the need for an optimization of the economic resources. In this study, the time course of the upper limb motor recovery of 24 subacute stroke patients undergoing a 30-session robotic or conventional treatment was analyzed through the upper extremity portion of the Fugl-Meyer Assessment scale (FMA-UE). The FMA-UE was administered before the treatment, and after 10, 20, and 30 rehabilitation sessions. Statistical analysis showed that, according to the FMA-UE, the time course in the two groups was similar: patients did not change between the baseline and the 10-session assessment, while they improved between 10 and 20 sessions, and between 20 and 30 sessions, with most of the gain observed between 10 and 20 sessions. This result suggests that 30-session robotic or conventional rehabilitation programs induce a similar curve trend in the upper limb motor recovery of patients with subacute stroke, with an important increase in the middle of the program and without reaching a clear plateau in the analyzed time interval.

摘要

上肢恢复是一个复杂的过程,也是中风患者康复过程中的一项严峻挑战。已经开展了多项研究来比较传统康复和机器人辅助康复在恢复中风后上肢运动功能障碍方面的疗效。然而,干预过程中上肢运动能力的变化情况,以及患者停止改善的时间点(即所谓的平台期)很少被测量,而且从未在两种方法之间进行过比较。考虑到优化经济资源的必要性,后两个方面非常重要。在本研究中,通过Fugl-Meyer评估量表(FMA-UE)的上肢部分,分析了24名接受30次机器人辅助治疗或传统治疗的亚急性中风患者的上肢运动恢复时间进程。在治疗前、10次、20次和30次康复治疗后进行FMA-UE评估。统计分析表明,根据FMA-UE,两组的时间进程相似:患者在基线和10次评估之间没有变化,而在10次至20次治疗之间以及20次至30次治疗之间有所改善,大部分改善出现在10次至20次治疗之间。这一结果表明,30次的机器人辅助康复或传统康复方案在亚急性中风患者的上肢运动恢复中诱导出相似的曲线趋势,在治疗过程中期有显著改善,并且在分析的时间间隔内未达到明显的平台期。

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