Yoon Bu Hyun, Park Chanhee, You Joshua Sung Hyun
Sports Movement Artificial-Intelligence Robotics Technology (SMART) Institute, Department of Physical Therapy, Yonsei University, Wonju 26493, Korea.
Department of Physical Therapy, Yonsei University, Wonju 26493, Korea.
Healthcare (Basel). 2022 Apr 6;10(4):691. doi: 10.3390/healthcare10040691.
Patients with hemiparetic stroke undergo direct, labor-intensive hands-on conventional physical therapy to improve sensorimotor function, spasticity, balance, trunk stability, and activities of daily living (ADLs). Currently, direct, intensive hands-on therapeutic modalities have increased concerns during the coronavirus (COVID-19) global pandemic. We developed an innovative Walkbot to mitigate the issues surrounding conventional hands-on physical therapy. We aimed to compare the effects of minimal-contact robotic rehabilitation (MRR) and full-contact conventional rehabilitation (FCR) on static and dynamic balance, trunk stability, ADLs, spasticity, and cognition changes in patients with hemiparetic stroke. A total of 64 patients with hemiparetic stroke (mean age = 66.38 ± 13.17; 27 women) underwent either MRR or FCR three times/week for 6 weeks. Clinical outcome measurements included the Trunk Impairment Scale (TIS), the Berg Balance Scale (BBS), the modified Ashworth Scale (MAS), the Fugl—Meyer Assessment (FMA), and the modified Barthel Index (MBI) scores. A 2 × 2 repeated analysis of variance (ANOVA) was performed, and an independent t-test was used to determine statistical differences in the physiotherapists’ work efficiency and COVID-19 transmission risk. The ANOVA showed that MRR had effects superior to those of FCR on the TIS, the BBS, the FMA, and the MBI (p < 0.05), but not on the MAS (p = 0.230). MRR showed a greater decrease on the physiotherapist’s work efficiency and COVID-19 transmission risk (p < 0.05). Our results provide clinical evidence that robot-assisted locomotor training helps maximize the recovery of sensorimotor function, abnormal synergy, balance, ADLs, and trunk stability, and facilitates a safer environment and less labor demand than conventional stroke rehabilitation.
偏瘫性中风患者需要接受直接的、劳动强度大的亲身传统物理治疗，以改善感觉运动功能、痉挛、平衡、躯干稳定性和日常生活活动（ADL）能力。目前，在冠状病毒病（COVID-19）全球大流行期间，直接的、高强度的亲身治疗方式引发了更多担忧。我们研发了一种创新的步行机器人，以缓解围绕传统亲身物理治疗的问题。我们旨在比较最小接触式机器人康复（MRR）和全接触式传统康复（FCR）对偏瘫性中风患者静态和动态平衡、躯干稳定性、ADL能力、痉挛及认知变化的影响。共有64例偏瘫性中风患者（平均年龄=66.38±13.17；27名女性）接受了MRR或FCR治疗，每周3次，共6周。临床结局测量包括躯干损伤量表（TIS）、伯格平衡量表（BBS）、改良Ashworth量表（MAS）、Fugl-Meyer评估（FMA）和改良Barthel指数（MBI）评分。进行了2×2重复方差分析（ANOVA），并使用独立t检验来确定物理治疗师工作效率和COVID-19传播风险的统计学差异。方差分析显示，在TIS、BBS、FMA和MBI方面，MRR的效果优于FCR（p<0.05），但在MAS方面则不然（p=0.230）。MRR在物理治疗师的工作效率和COVID-19传播风险方面有更大程度的降低（p<0.05）。我们的结果提供了临床证据，表明机器人辅助运动训练有助于最大限度地恢复感觉运动功能、异常协同、平衡、ADL能力和躯干稳定性，并营造比传统中风康复更安全的环境，且劳动力需求更少。
