Patricia Danz, MS, OTR/L, CSRP, is Clinical Specialist and Occupational Therapist, Department of Physical Medicine and Rehabilitation, Johns Hopkins Bayview Medical Center, Baltimore, MD;
Kacy Wesselman, MS, OTR/L, CSRP, is Clinical Specialist and Occupational Therapist, Department of Physical Medicine and Rehabilitation, Johns Hopkins Bayview Medical Center, Baltimore, MD.
Am J Occup Ther. 2024 Nov 1;78(6). doi: 10.5014/ajot.2024.050784.
Upper extremity (UE) dysfunction resulting from stroke significantly affects a person's ability to complete self-care activities, consequently diminishing functional independence. Effective interventions that improve UE function in persons with stroke are needed.
To explore the effectiveness of the Bimanual Arm Trainer (BAT) compared with traditional occupational therapy treatment sessions (i.e., a control group) on improving UE function after acute ischemic stroke.
Clinical trial, two-group, nonrandomized repeated-measures design.
Inpatient rehabilitation facility.
Twenty-seven persons with ischemic stroke and an Action Research Arm Test (ARAT) score ≤17.
Minimum of three 10-min sessions on the BAT.
ARAT, Upper Extremity Fugl-Meyer Assessment of Motor Recovery after Stroke (FMA-UE).
Both the intervention and control groups showed significant improvement on the ARAT from evaluation to discharge (main effect of time: p = .02). There was no statistically significant main effect of group and no significant Time × Group interaction (p = .63). FMA-UE scores also improved significantly in the intervention group from evaluation to discharge (p < .001). FMA-UE scores were not available for the control group.
Both the intervention and control groups demonstrated significant improvements in UE function from evaluation to discharge. There were no statistically significant differences between groups, indicating that the BAT results in similar improvements in UE function, as would be expected in traditional occupational therapy. Further research is warranted to examine additional BAT programs, use different outcome measures, and assess participants over a longer time span. Plain-Language Summary: The Bimanual Arm Trainer (BAT) is a novel device that can be used in occupational therapy to improve arm function among stroke patients. There is limited research on BAT's effectiveness in improving arm function among stroke patients. In an acute inpatient rehabilitation setting, we compared outcome scores of patients who received traditional occupational therapy services with those who also used the BAT. Both groups achieved significant improvements in arm function from evaluation to discharge. We found that the addition of the BAT interventions did not significantly affect the outcome measure scores for either group. We conclude that more research is needed to examine additional BAT programs, use different outcome measures, and assess participants over a longer period of time.
上肢（UE）功能障碍是由中风引起的，这会显著影响一个人完成自理活动的能力，从而降低其功能独立性。需要有效的干预措施来改善中风患者的 UE 功能。
探索双手臂训练器（BAT）与传统职业治疗治疗课程（即对照组）相比，在改善急性缺血性中风后 UE 功能方面的有效性。
临床试验，两组，非随机重复测量设计。
住院康复设施。
27 名缺血性中风患者，动作研究上肢测试（ARAT）得分≤17。
至少进行 3 次 10 分钟的 BAT 治疗。
ARAT、中风后上肢 Fugl-Meyer 运动恢复评定（FMA-UE）。
干预组和对照组在 ARAT 评估至出院期间均有显著改善（时间主效应：p =.02）。组间无统计学显著主效应，无时间与组间交互作用（p =.63）。干预组 FMA-UE 评分也从评估到出院显著提高（p < .001）。对照组 FMA-UE 评分不可用。
干预组和对照组在 UE 功能从评估到出院均有显著改善。组间无统计学显著差异，表明 BAT 可改善 UE 功能，与传统职业治疗相似。需要进一步研究，以检验其他 BAT 方案，使用不同的结局测量指标，并评估更长时间跨度的参与者。
通俗译文：双手臂训练器（BAT）是一种新型设备，可用于职业治疗，以改善中风患者的手臂功能。BAT 改善中风患者手臂功能的有效性的研究有限。在急性住院康复环境中，我们比较了接受传统职业治疗服务的患者和同时使用 BAT 的患者的结果评分。两组从评估到出院手臂功能均有显著改善。我们发现，加入 BAT 干预措施并没有显著影响两组的结果测量评分。我们的结论是，需要进一步研究，以检验其他 BAT 方案，使用不同的结果测量指标，并评估更长时间跨度的参与者。
