Casas Rafael, Sandison Melissa, Nichols Diane, Martin Kaelin, Phan Khue, Chen Tianyao, Lum Peter S
Biomedical Engineering, The Catholic University of America, Washington, DC, United States.
MedStar National Rehabilitation Network, Washington, DC, United States.
Front Neurorobot. 2021 Dec 17;15:773477. doi: 10.3389/fnbot.2021.773477. eCollection 2021.
We have developed a passive and lightweight wearable hand exoskeleton (HandSOME II) that improves range of motion and functional task practice in laboratory testing. For this longitudinal study, we recruited 15 individuals with chronic stroke and asked them to use the device at home for 1.5 h per weekday for 8 weeks. Subjects visited the clinic once per week to report progress and troubleshoot problems. Subjects were then given the HandSOME II for the next 3 months, and asked to continue to use it, but without any scheduled contact with the project team. Clinical evaluations and biomechanical testing was performed before and after the 8 week intervention and at the 3 month followup. EEG measures were taken before and after the 8 weeks of training to examine any recovery associated brain reorganization. Ten subjects completed the study. After 8 weeks of training, functional ability (Action Research Arm Test), flexor tone (Modified Ashworth Test), and real world use of the impaired limb (Motor Activity Log) improved significantly ( < 0.05). Gains in real world use were retained at the 3-month followup ( = 0.005). At both post-training and followup time points, biomechanical testing found significant gains in finger ROM and hand displacement in a reaching task ( < 0.05). Baseline functional connectivity correlated with gains in motor function, while changes in EEG functional connectivity paralleled changes in motor recovery. HandSOME II is a low-cost, home-based intervention that elicits brain plasticity and can improve functional motor outcomes in the chronic stroke population.
我们研发了一种被动式、轻便的可穿戴手部外骨骼（HandSOME II），在实验室测试中，它能改善活动范围和功能任务练习。在这项纵向研究中，我们招募了15名慢性中风患者，要求他们在工作日每天在家使用该设备1.5小时，持续8周。受试者每周到诊所一次，汇报进展并解决问题。之后，受试者在接下来的3个月内继续使用HandSOME II，但无需与项目团队进行任何定期联系。在8周干预前后以及3个月随访时进行了临床评估和生物力学测试。在8周训练前后进行脑电图测量，以检查与恢复相关的大脑重组情况。10名受试者完成了研究。经过8周训练后，功能能力（动作研究臂测试）、屈肌肌张力（改良Ashworth测试）以及患侧肢体在现实生活中的使用情况（运动活动日志）均有显著改善（<0.05）。在3个月随访时，现实生活中的使用改善情况得以保持（=0.005）。在训练后和随访这两个时间点，生物力学测试均发现，在伸手任务中手指活动范围和手部位移有显著改善（<0.05）。基线功能连接性与运动功能的改善相关，而脑电图功能连接性的变化与运动恢复的变化平行。HandSOME II是一种低成本的居家干预措施，可引发大脑可塑性，并能改善慢性中风患者的运动功能结局。
