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家庭护理手臂康复(MERLIN):基于严肃游戏的无源设备远程康复可改善慢性脑卒中患者的上肢功能。

HoMEcare aRm rehabiLItatioN (MERLIN): telerehabilitation using an unactuated device based on serious games improves the upper limb function in chronic stroke.

机构信息

Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.

Neurorehabilitation Area, Health Division of TECNALIA, Basque Research and Technology Alliance (BRTA), San Sebastian, Spain.

出版信息

J Neuroeng Rehabil. 2021 Mar 16;18(1):48. doi: 10.1186/s12984-021-00841-3.

Abstract

BACKGROUND

HoMEcare aRm rehabiLItatioN (MERLIN) is an unactuated version of the robotic device ArmAssist combined with a telecare platform. Stroke patients are able to train the upper limb function using serious games at home. The aim of this study is to investigate the effect of MERLIN training on the upper limb function of patients with unilateral upper limb paresis in the chronic phase of stroke (> 6 months post stroke).

METHODS

Patients trained task specific serious games for three hours per week during six weeks using an unactuated version of a robotic device. Progress was monitored and game settings were tailored through telerehabilitation. Measurements were performed six weeks pre-intervention (T0), at the start (T1), end (T2) and six weeks post-intervention (T3). Primary outcome was the Wolf Motor Function Test (WMFT). Secondary outcomes were other arm function tests, quality of life, user satisfaction and motivation.

RESULTS

Twelve patients were included, ten completed the training. From start of the intervention to six weeks follow up, WMFT improved significantly with 3.8 points (p = .006), which is also clinically relevant. No significant changes in quality of life were observed. Patients were overall satisfied with the usability of the device. Comfort and the robustness of the system need further improvements.

CONCLUSION

Patients in the chronic phase of stroke significantly improved their upper limb function with the MERLIN training at home. Trial registration This study is registered at the Netherlands Trial Register (NL7535). Registered 18-02-2019, https://www.trialregister.nl/trial/7535 .

摘要

背景

HoMEcare aRm rehabiLItatioN(MERLIN)是一种与远程医疗平台相结合的无动力机器人设备 ArmAssist 的版本。中风患者可以在家中使用严肃游戏来训练上肢功能。本研究旨在探讨 MERLIN 训练对中风后慢性期(>6 个月)单侧上肢瘫痪患者上肢功能的影响。

方法

患者使用无动力机器人设备进行每周 3 小时、为期 6 周的专项严肃游戏训练。通过远程康复来监测进展并调整游戏设置。在干预前 6 周(T0)、开始时(T1)、结束时(T2)和干预后 6 周(T3)进行测量。主要结果是 Wolf 运动功能测试(WMFT)。次要结果包括其他上肢功能测试、生活质量、用户满意度和动机。

结果

共纳入 12 例患者,其中 10 例完成了训练。从干预开始到 6 周随访,WMFT 显著提高了 3.8 分(p=0.006),这也是具有临床意义的。生活质量没有显著变化。患者对设备的可用性总体满意。舒适性和系统的稳健性需要进一步改进。

结论

中风慢性期患者在家中使用 MERLIN 训练显著提高了上肢功能。

试验注册

本研究在荷兰试验注册中心(NL7535)注册。注册日期为 2019 年 2 月 18 日,https://www.trialregister.nl/trial/7535。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bd75/7962368/431021de41a4/12984_2021_841_Fig1_HTML.jpg

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