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机器人辅助被动关节活动度训练结合常规康复治疗对慢性脑卒中患者手部功能的可行性和潜在影响。

Feasibility and Potential Effects of Robot-Assisted Passive Range of Motion Training in Combination with Conventional Rehabilitation on Hand Function in Patients with Chronic Stroke.

机构信息

Department of Rehabilitation Medicine, Ten-Chan General Hospital; Department of Biomedical Engineering, Chung Yuan Christian University.

Department of Rehabilitation Medicine, Ten-Chan General Hospital.

出版信息

J Rehabil Med. 2022 Aug 26;54:jrm00323. doi: 10.2340/jrm.v54.1407.

Abstract

OBJECTIVE

To assess the effects of exoskeleton robot-assisted passive range of motion for induction training in combination with conventional hand rehabilitation in patients with chronic stroke.

DESIGN

Single-cohort feasibility study.

SUBJECTS

Chronic stroke with severe upper extremity hemiparesis.

METHODS

Thirty sessions of therapy over a period of 10 weeks. Each session started with 30 min robot-assisted passive range of motion for the hand, followed by 30 min conventional hand rehabilitation. The Fugl-Meyer Assessment for upper extremity, arm subscore of Motricity Index, Functional Independence Measure and Fugl-Meyer assessment for sensation (Fugl-Meyer assessment-sensory) were conducted at pre-intervention (pre) and after the 16th (16-post) and 30th (30-post) sessions of interventions.

RESULTS

Twelve patients with chronic stroke were recruited. The Fugl-Meyer assessment for upper extremity (16-post vs 30-post, p = 0.011), arm subscore of Motricity Index (pre vs 30-post, p = 0.012) and Functional Independence Measure (pre vs 30-post, p = 0.007; 16- post vs 30-post, p = 0.016) improved significantly after the therapy. However, FMA-sensory did not change significantly.

CONCLUSION

Exoskeleton robot-assisted passive range of motion of the hand using an exoskeleton can be considered as an induction therapy before starting conventional therapy for hand rehabilitation in patients with chronic stroke. Further randomized control trials are needed to verify the therapeutic benefits.

摘要

目的

评估外骨骼机器人辅助被动关节活动度训练联合常规手部康复治疗对慢性脑卒中患者的诱导作用。

设计

单队列可行性研究。

受试者

慢性脑卒中伴严重上肢偏瘫。

方法

10 周内进行 30 次治疗,每次治疗先进行 30 分钟的手部外骨骼机器人辅助被动关节活动度训练,然后进行 30 分钟的常规手部康复治疗。在干预前(pre)、第 16 次(16-post)和第 30 次(30-post)治疗后,分别进行 Fugl-Meyer 上肢评估、运动评估量表上肢亚量表、功能独立性测量和感觉 Fugl-Meyer 评估(Fugl-Meyer assessment-sensory)。

结果

共纳入 12 例慢性脑卒中患者。上肢 Fugl-Meyer 评估(16-post 与 30-post,p = 0.011)、运动评估量表上肢亚量表(pre 与 30-post,p = 0.012)和功能独立性测量(pre 与 30-post,p = 0.007;16-post 与 30-post,p = 0.016)在治疗后显著改善,但 FMA-sensory 无显著变化。

结论

外骨骼机器人辅助的手部被动关节活动度训练可作为慢性脑卒中患者开始常规手部康复治疗前的诱导治疗。需要进一步的随机对照试验来验证其治疗效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cdcb/9463634/5df76a75aa9a/JRM-54-1407-g001.jpg

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