Patel Jigna, Qiu Qinyin, Fluet Gerard G, Gorin Holly, Gutterman Jennifer, Karunakaran Kiran, Nolan Karen J, Kaplan Emma, Merians Alma S, Adamovich Sergei V
Department of Rehabilitation and Movement Sciences, School of Health Professions, Rutgers The State University of New Jersey, 65 Bergen St, Newark, NJ, 07101, USA.
Kessler Foundation, West Orange, NJ, 07052, USA.
Sci Rep. 2025 Apr 22;15(1):13834. doi: 10.1038/s41598-025-98618-4.
Many people with stroke experience incomplete recoveries, leaving them with upper extremity (UE) deficits affecting their long-term independence. Interventions including virtual reality (VR) and robotics have been developed to foster neuroplasticity post stroke. Few of the many studies examining these interventions consider the impact of both timing and dosage. The primary aim of this randomized controlled trial was to investigate (1) dosage and (2) timing of UE VR/robotic training in the subacute period post stroke. 100 participants were consented 5-30 days after stroke. They were randomized to an Early (first month) or Delayed (second month) VR/robotic group (EVR/DVR), a dose matched usual care group (DMUC) or a usual care group (UC). Participants were evaluated using impairment, motor function, and quality of life measures immediately before, after, and 1 month after training, and 4 and 6 months post stroke. At 4 months post stroke the DVR group showed a higher rate of change from baseline on the Action Research Arm Test compared to the EVR group. This difference was not sustained; none of the training groups demonstrated significantly better scores on any outcome measure 6 months post stroke. Growth mixture modeling revealed three groups with patterns of recovery associated with early finger movement. At 6 months post stroke, the EuroQol was moderately correlated with impairment and activity.
许多中风患者恢复不完全，上肢（UE）存在功能缺陷，影响其长期的独立生活能力。为促进中风后的神经可塑性，已开发出包括虚拟现实（VR）和机器人技术在内的干预措施。在众多研究这些干预措施的研究中，很少有研究考虑时间和剂量的影响。这项随机对照试验的主要目的是研究（1）中风亚急性期UE VR/机器人训练的剂量和（2）时间。100名参与者在中风后5至30天同意参与试验。他们被随机分为早期（第一个月）或延迟（第二个月）VR/机器人组（EVR/DVR）、剂量匹配的常规护理组（DMUC）或常规护理组（UC）。在训练前、训练后、训练后1个月、中风后4个月和6个月，使用损伤、运动功能和生活质量指标对参与者进行评估。在中风后4个月，与EVR组相比，DVR组在行动研究臂测试中显示出更高的相对于基线的变化率。这种差异没有持续；在中风后6个月，没有一个训练组在任何结果指标上表现出明显更好的分数。生长混合模型显示出三组与早期手指运动相关的恢复模式。在中风后6个月，欧洲生活质量量表与损伤和活动呈中度相关。
