Department of Biomedical Engineering, the Chinese University of Hong Kong, Hong Kong.
Department of Surgery, the Chinese University of Hong Kong, Hong Kong.
J Stroke Cerebrovasc Dis. 2021 Jul;30(7):105812. doi: 10.1016/j.jstrokecerebrovasdis.2021.105812. Epub 2021 Apr 22.
Soft robotic hands are proposed for stroke rehabilitation in terms of their high compliance and low inherent stiffness. We investigated the clinical efficacy of a soft robotic hand that could actively flex and extend the fingers in chronic stroke subjects with different levels of spasticity.
Sixteen chronic stroke subjects were recruited into this single-group study. Subjects underwent 20 sessions of 1-hour EMG-driven soft robotic hand training. Training effect was evaluated by the pre-training and post-training assessments with the clinical scores: Action Research Arm Test(ARAT), Fugl-Meyer Assessment for Upper Extremity(FMA-UE), Box-and-Block test(BBT), Modified Ashworth Scale(MAS), and maximum voluntary grip strength.
For all the recruited subjects (n = 16), significant improvement of upper limb function was generally observed in ARAT (increased mean=2.44, P = 0.032), FMA-UE (increased mean=3.31, P = 0.003), BBT (increased mean=1.81, P = 0.024), and maximum voluntary grip strength (increased mean=2.14 kg, P < 0.001). No significant change was observed in terms of spasticity with the MAS (decreased mean=0.11, P = 0.423). Further analysis showed subjects with mild or no finger flexor spasticity (MAS<2, n = 9) at pre-training had significant improvement of upper limb function after 20 sessions of training. However, for subjects with moderate and severe finger flexor spasticity (MAS=2,3, n = 7) at pre-training, no significant change in clinical scores was shown and only maximum voluntary grip strength had significant increase.
EMG-driven rehabilitation training using the soft robotic hand with flexion and extension could be effective for the functional recovery of upper limb in chronic stroke subjects with mild or no spasticity.
柔性机器人手具有高顺应性和低固有刚度的特点，因此被提出用于中风康复。我们研究了一种能够主动弯曲和伸展手指的柔性机器人手在不同痉挛程度的慢性中风患者中的临床疗效。
本研究纳入了 16 名慢性中风患者，进行了 20 次 1 小时的肌电驱动软性机器人手训练。通过临床评分：动作研究上肢测试（ARAT）、上肢 Fugl-Meyer 评估（FMA-UE）、箱-块测试（BBT）、改良 Ashworth 量表（MAS）和最大自主握力，在训练前和训练后对训练效果进行评估。
对于所有纳入的患者（n=16），上肢功能通常在 ARAT（平均增加 2.44，P=0.032）、FMA-UE（平均增加 3.31，P=0.003）、BBT（平均增加 1.81，P=0.024）和最大自主握力（平均增加 2.14 公斤，P<0.001）方面有显著改善。MAS （平均减少 0.11，P=0.423）方面的痉挛无显著变化。进一步分析表明，在训练前 MAS<2 的轻度或无手指屈肌痉挛患者（n=9），经过 20 次训练后，上肢功能有显著改善。然而，在训练前 MAS=2、3 的中度和重度手指屈肌痉挛患者（n=7）中，临床评分没有明显变化，只有最大自主握力有显著增加。
肌电驱动的软性机器人手的弯曲和伸展康复训练可能对轻度或无痉挛的慢性中风患者上肢功能的恢复有效。
