IRCCS Fondazione Don Carlo Gnocchi ONLUS, Florence, Italy.
NeuroRehabilitation. 2024;54(3):411-420. doi: 10.3233/NRE-230367.
Many authors have emphasized the need for individualized treatments in rehabilitation, but no tailored robotic rehabilitation protocol for stroke patients has been established yet.
To evaluate the effectiveness of a robot-mediated upper limb rehabilitation protocol based on clinical assessment for customized treatment of stroke patients.
Clinical data from 81 patients with subacute stroke, undergoing an upper limb robot-mediated rehabilitation, were analyzed retrospectively. 49 patients were treated using a customized robotic protocol (experimental group, EG) based on a clinically guided flowchart, while 32 were treated without it (control group, CG). Fugl-Meyer Assessment for Upper Extremity (FMA-UE), Motricity Index (MI), modified Barthel Index (mBI) and Numerical Rating Scale (NRS) measured before (T0) and after (T1) rehabilitation intervention were used as clinical outcomes.
There was statistically significant improvement in both groups in terms of FMA-UE, MI, and mBI, while no change in NRS. Intergroup analysis showed significantly greater improvement of the FMA-UE (P = 0.002) and MI (P < 0.001) in the EG, compared with the CG.
The implementation of our robotic protocol for customized treatment of stroke patients yielded greater recovery in upper limb motor function and strength over robotic treatment without a defined protocol.
许多作者强调了在康复中进行个体化治疗的必要性，但尚未建立针对脑卒中患者的定制机器人康复方案。
评估基于临床评估的机器人辅助上肢康复方案在脑卒中患者个体化治疗中的有效性。
回顾性分析了 81 例亚急性期脑卒中患者接受上肢机器人辅助康复治疗的临床数据。其中 49 例采用基于临床指导流程图的个体化机器人方案（实验组，EG）进行治疗，32 例采用无该方案的常规机器人治疗（对照组，CG）。采用 Fugl-Meyer 上肢评估量表（FMA-UE）、运动指数（MI）、改良巴氏指数（mBI）和数字评分量表（NRS）作为临床疗效评价指标，分别在治疗前（T0）和治疗后（T1）进行评估。
两组患者的 FMA-UE、MI 和 mBI 均有显著改善，而 NRS 无变化。组间分析显示，实验组在 FMA-UE（P = 0.002）和 MI（P < 0.001）方面的改善明显优于对照组。
与无明确方案的机器人治疗相比，我们的机器人方案在脑卒中患者的个体化治疗中，上肢运动功能和力量的恢复效果更好。
