Pavan Arianna, Fasano Alessio, Lattanzi Stefania, Cortellini Laura, Cipollini Valeria, Insalaco Sabina, Mauro Maria Cristina, Germanotta Marco, Aprile Irene Giovanna
Neuromotor Rehabilitation Department, IRCCS Fondazione Don Carlo Gnocchi ONLUS, 50143 Florence, Italy.
Brain Sci. 2024 Sep 21;14(9):941. doi: 10.3390/brainsci14090941.
BACKGROUND/OBJECTIVES: Finding innovative digital solutions is fundamental to ensure prompt and continuous care for patients with chronic neurological disorders, whose demand for rehabilitation also in home-based settings is steadily increasing. The aim is to verify the safety and the effectiveness of two telerehabilitation (TR) models in improving recovery from subacute upper limb (UL) disability after stroke, with and without a robotic device.
One hundred nineteen subjects with subacute post-stroke UL disability were assessed for eligibility. Of them, 30 patients were enrolled in the study and randomly assigned to either the Robotic Group (RG), undergoing a 20-session TR program, using a robotic device, or the Non-Robotic Group (NRG), undergoing a 20-session TR program without robotics. Clinical evaluations were measured at baseline (T0) and post-intervention (T1, 5 weeks after baseline), and included assessments of quality of life, motor skills, and clinical/functional status. The primary outcome measure was the World Health Organization Disability Assessment Schedule 2.0, evaluating the change in perceived disability.
Statistical analysis shows that patients of both groups improved significantly over time in all domains analyzed (mean decrease from baseline in the WHODAS 2.0 of 6.09 ± 2.62% for the NRG, and of 0.76 ± 2.21% for the RG), with a greater improvement of patients in the NRG in motor (Fugl-Meyer Assessment Upper Extremity-motor function, Box and Block Test) and cognitive skills (Trail Making Test-A).
This study highlights the potential of TR programs to transform stroke rehabilitation by enhancing accessibility and patient-centered care, promoting autonomy, improving adherence, and leading to better outcomes and quality of life for stroke survivors.
背景/目的：寻找创新的数字解决方案对于确保为慢性神经疾病患者提供及时且持续的护理至关重要，这类患者对居家康复的需求也在稳步增加。目的是验证两种远程康复（TR）模式在改善卒中后亚急性期上肢（UL）残疾恢复方面的安全性和有效性，一种有机器人设备，另一种没有。
对119名患有亚急性期卒中后UL残疾的受试者进行资格评估。其中，30名患者被纳入研究，并随机分配到机器人组（RG），使用机器人设备进行为期20节的TR计划，或非机器人组（NRG），进行为期20节的无机器人TR计划。在基线（T0）和干预后（T1，基线后5周）进行临床评估，包括生活质量、运动技能和临床/功能状态评估。主要结局指标是世界卫生组织残疾评估量表2.0，评估感知残疾的变化。
统计分析表明，两组患者在所有分析领域均随时间显著改善（NRG的WHODAS 2.0从基线的平均下降为6.09±2.62%，RG为0.76±2.21%），NRG患者在运动（Fugl-Meyer评估上肢运动功能、箱块测试）和认知技能（连线测验-A）方面改善更大。
本研究强调了TR计划通过提高可及性和以患者为中心的护理、促进自主性、提高依从性，并为卒中幸存者带来更好的结局和生活质量，从而改变卒中康复的潜力。
