Roessingh Research and Development, Roessinghsbleekweg 33b 7522AH, Enschede, The Netherlands; University of Twente, Department of Biomechanical Engineering, Faculty of Engineering Technology, Drienerlolaan 5 7522NB, Enschede, The Netherlands.
Aalborg University, The neurorehabilitation Robotics and Engineering group, Center for Rehabilitation in Robotics, Department of Health Science and Technology, Gistrup 9260, Denmark.
Med Eng Phys. 2024 Aug;130:104216. doi: 10.1016/j.medengphy.2024.104216. Epub 2024 Aug 3.
Rehabilitation technology can be used to provide intensive training in the early phases after stroke. The current study aims to assess the feasibility of combining robotics and functional electrical stimulation (FES), with an assist-as-needed approach to support actively-initiated leg movements in (sub-)acute stroke patients.
Nine subacute stroke patients performed repetitions of ankle dorsiflexion and/or knee extension movements, with and without assistance. The assist-as-needed algorithm determined the amount and type of support needed per repetition. The number of repetitions and range of motion with and without assistance were compared with descriptive statistics. Fatigue scores were obtained using the visual analogue scale (score 0-10).
Support was required in 44 % of the repetitions for ankle dorsiflexion and in 5 % of the repetitions of knee extension, The median fatigue score was 2.0 (IQR: 0.2) and 4.0 (IQR: 1.5) for knee and ankle, respectively, indicating mild to moderate perceived fatigue.
This study demonstrated the feasibility of assist-as-needed assistance through combined robotic and FES support of leg movements in stroke patients. It proved particularly useful for ankle dorsiflexion. Future research should focus on implementing this approach in a clinical setting, to assess clinical applicability and potential effects on leg function.
康复技术可用于在中风后早期提供强化训练。本研究旨在评估结合机器人和功能性电刺激（FES）的可行性，采用按需辅助方法，为（亚）急性中风患者主动发起的腿部运动提供支持。
9 名亚急性中风患者进行踝关节背屈和/或膝关节伸展运动的重复动作，有辅助和无辅助两种情况。按需辅助算法确定了每个重复动作所需的辅助量和类型。比较了有辅助和无辅助情况下的重复次数和运动范围，并进行了描述性统计。使用视觉模拟量表（得分 0-10）获得疲劳评分。
踝关节背屈的重复动作中有 44%需要辅助，膝关节伸展的重复动作中有 5%需要辅助。膝关节和踝关节的平均疲劳评分为 2.0（IQR：0.2）和 4.0（IQR：1.5），表明疲劳程度为轻度至中度。
本研究证明了通过机器人和 FES 联合支持中风患者腿部运动的按需辅助的可行性。它对踝关节背屈特别有用。未来的研究应侧重于在临床环境中实施这种方法，以评估其临床适用性和对腿部功能的潜在影响。
