Iwamoto Yuji, Tanaka Ryo, Imura Takeshi, Mitsutake Tsubasa, Jung Hungu, Suzukawa Takahiro, Taki Shingo, Imada Naoki, Inagawa Tetsuji, Araki Hayato, Araki Osamu
Department of Rehabilitation, Araki Neurosurgical Hospital, Hiroshima, Japan.
Graduate School of Humanities and Social Sciences, Hiroshima University, Hiroshima, Japan.
Disabil Rehabil. 2023 Apr;45(7):1185-1191. doi: 10.1080/09638288.2022.2055163. Epub 2022 Mar 25.
To determine how differences in frequency of the single-joint hybrid assistive limb (HAL-SJ) use affect the improvement of upper limb motor function and activities of daily living (ADL) in stroke patients.
Subacute stroke patients were divided into the high or low frequency of HAL-SJ use groups. The two groups were matched by propensity score, and the degree of changes 30 days after initiating HAL-SJ use was compared. A logistic regression analysis was performed to examine whether frequent use would increase the number of subjects experiencing the efficacy of more than the minimal clinically important difference (MCID) of Fugl-Meyer assessment (FMA).
Twenty-five stroke patients were matched by propensity score, and nine pairs were matched. The high-frequency group showed a significantly superior increase to total FMA shoulder, elbow, forearm, and Barthel index compared with the low-frequency group. Logistic regression analysis revealed no significant associations between frequent use and MCID.
The frequency of HAL-SJ use may affect the improvement of motor function and ADL ability of the upper limb with exception of the fingers and wrist. However, the frequency of intervention was not effective enough to further increase the number of subjects with clinically meaningful changes in upper limb motor function.IMPLICATIONS FOR REHABILITATIONThe current study aimed to clarify how differences in the frequency of single-joint hybrid assistive limb (HAL-SJ) use can affect the improvement of upper-limb motor functions and ADL in subacute stroke patients.Our results implied that the frequency of HAL-SJ use may influence the recovery of upper limb function.However, even if HAL-SJ is used frequently, it does not mean that more patients will achieve clinically meaningful recovery.
确定单关节混合辅助肢体（HAL-SJ）使用频率的差异如何影响中风患者上肢运动功能和日常生活活动（ADL）的改善。
将亚急性中风患者分为HAL-SJ使用频率高或低的组。通过倾向评分对两组进行匹配，并比较开始使用HAL-SJ后30天的变化程度。进行逻辑回归分析，以检查频繁使用是否会增加Fugl-Meyer评估（FMA）中超过最小临床重要差异（MCID）的有效人数。
25名中风患者通过倾向评分进行匹配，匹配出9对。高频组与低频组相比，FMA肩部、肘部、前臂总分及Barthel指数的增加显著更优。逻辑回归分析显示频繁使用与MCID之间无显著关联。
HAL-SJ的使用频率可能会影响除手指和手腕外的上肢运动功能和ADL能力的改善。然而，干预频率不足以进一步增加上肢运动功能有临床意义变化的患者数量。
本研究旨在阐明单关节混合辅助肢体（HAL-SJ）使用频率的差异如何影响亚急性中风患者上肢运动功能和ADL的改善。我们的结果表明，HAL-SJ的使用频率可能会影响上肢功能的恢复。然而，即使频繁使用HAL-SJ，也并不意味着更多患者会实现有临床意义的恢复。
