P.A.N. Zentrum für Post-Akute Neurorehabilitation, Fürst Donnersmarck-Stiftung zu Berlin, Berlin, Germany.
School of Psychology, University of Surrey, Guildford, UK.
Restor Neurol Neurosci. 2022;40(3):185-194. doi: 10.3233/RNN-221263.
Standard mirror therapy (MT) is a well-established therapy regime for severe arm paresis after acquired brain injury. Bilateral robot-assisted mirror therapy (RMT) could be a solution to provide visual and somatosensory feedback simultaneously.
The study compares the treatment effects of MT with a version of robot-assisted MT where the affected arm movement was delivered through a robotic glove (RMT).
This is a parallel, randomized trial, including patients with severe arm paresis after stroke or traumatic brain injury with a Fugl-Meyer subscore hand/finger < 4. Participants received either RMT or MT in individual 30 minute sessions (15 sessions within 5 weeks). Main outcome parameter was the improvement in the Fugl-Meyer Assessment upper extremity (FMA-UE) motor score. Additionally, the Motricity Index (MI) and the FMA-UE sensation test as well as a pain scale were recorded. Furthermore, patients' and therapists' experiences with RMT were captured through qualitative tools.
24 patients completed the study. Comparison of the FMA-UE motor score difference values between the two groups revealed a significantly greater therapy effect in the RMT group than the MT group (p = 0.006). There were no significant differences for the MI (p = 0.108), the FMA-UE surface sensibility subscore (p = 0.403) as well as the FMA-UE position sense subscore (p = 0.192). In both groups the levels of pain remained stable throughout the intervention. No other adverse effects were observed. The RMT training was well accepted by patients and therapists.
The study provides evidence that bilateral RMT achieves greater treatment benefit on motor function than conventional MT. The use of robotics seems to be a good method to implement passive co-movement in clinical practice. Our study further demonstrates that this form of training can feasibly and effectively be delivered in an inpatient setting.
标准镜像疗法（MT）是一种经过验证的治疗获得性脑损伤后严重手臂瘫痪的方法。双侧机器人辅助镜像疗法（RMT）可以通过机器人手套同时提供视觉和体感反馈。
本研究比较了 MT 与一种机器人辅助 MT 版本的治疗效果，其中受影响的手臂运动通过机器人手套传递。
这是一项平行、随机试验，包括因中风或创伤性脑损伤导致手部/手指 Fugl-Meyer 亚评分 < 4 的严重手臂瘫痪患者。患者接受 RMT 或 MT 的个体 30 分钟疗程（5 周内 15 次）。主要结局参数是 Fugl-Meyer 上肢评估（FMA-UE）运动评分的改善。此外，还记录了运动指数（MI）和 FMA-UE 感觉测试以及疼痛量表。此外，还通过定性工具记录了患者和治疗师对 RMT 的体验。
24 名患者完成了研究。对两组 FMA-UE 运动评分差值的比较表明，RMT 组的治疗效果明显优于 MT 组（p = 0.006）。MI（p = 0.108）、FMA-UE 表面感觉子评分（p = 0.403）和 FMA-UE 位置感觉子评分（p = 0.192）均无显著差异。两组患者的疼痛水平在整个干预过程中保持稳定。未观察到其他不良反应。RMT 训练受到患者和治疗师的好评。
本研究提供了证据表明，双侧 RMT 在运动功能方面比传统 MT 更能获得更大的治疗益处。机器人的使用似乎是在临床实践中实施被动协同运动的一种很好的方法。我们的研究进一步表明，这种形式的训练可以在住院环境中有效地进行。
