智能机器人辅助训练系统结合重复性促进训练对脑卒中后上肢运动功能的有效性：一项随机对照试验
Effectiveness of intelligent robotic-assisted training system combined with repetitive facilitative exercise on upper limb motor function after stroke: a randomized controlled trial.
作者信息
Zhang Jing-Zhi, Chen Jun, Liu Xiao-Long, Yan Lin-Bo, Xu Si-Mao
机构信息
Department of Rehabilitation Therapy, Nanjing Mingzhou Rehabilitation Hospital, Nanjing, China.
Mingzhou Institute of Rehabilitation Medicine, Ningbo, China.
出版信息
BMC Sports Sci Med Rehabil. 2025 Jul 3;17(1):178. doi: 10.1186/s13102-025-01234-y.
BACKGROUND
Intelligent robotic-assisted training (IRAT) has been proven to improve upper limb motor function after stroke, but it needs to be combined with other treatment methods to achieve better results. Neuromuscular facilitation manipulation is a common series of therapies for stroke clinical practice, and the Repetitive facilitative exercise (RFE) developed based on it has been widely applied. This study aims to investigate the effectiveness of IRAT combined with RFE on upper limb motor function in stroke patients.
METHODS
In this three-arm, single-blind randomized controlled trial, 76 patients with stroke were randomly assigned to the IRAT group (n = 25), the RFE group (n = 26) and the conventional therapy (CT) group (n = 25). The IRAT group received IRAT combined with RFE. The RFE group received only RFE. The CT group received conventional therapy. Interventions were administered five times weekly for four weeks. The primary outcome measure was upper limb motor function, assessed using the Fugl-Meyer assessment for upper extremity (FMA-UE) scale. Assessment instruments included with IRAT system provided additional measures, including kinematic reach range (KRR), active participation proportion (APP), trajectory deviation (TD), and trajectory tracking error (TTE).
RESULTS
Demographic properties differences among the three groups were not significant (p > 0.05). At baseline, the groups did not differ significantly (p > 0.05). FMA-UE, KRR and APP increased significantly (p < 0.05) in all groups. TD and TTE decreased significantly (p < 0.05) in all groups. Post-intervention, the IRAT group showed significantly higher FMA-UE, KRR and APP scores compared to the RFE and CT groups. Additionally, TD and TTE were significantly lower in the IRAT group than in the RFE and CT groups.
CONCLUSION
IRAT combined with RFE was more effective in improving the upper limb motor function than RFE or CT after stroke.
TRIAL REGISTRATION
This study was registered at https://www.
CLINICALTRIALS
gov/ (NCT06435624; May 24, 2024).
背景
智能机器人辅助训练（IRAT）已被证明可改善中风后的上肢运动功能，但需要与其他治疗方法相结合以取得更好的效果。神经肌肉促进手法是中风临床实践中常用的一系列治疗方法，基于此开发的重复促进运动（RFE）已得到广泛应用。本研究旨在探讨IRAT联合RFE对中风患者上肢运动功能的有效性。
方法
在这项三臂、单盲随机对照试验中，76例中风患者被随机分配至IRAT组（n = 25）、RFE组（n = 26）和传统治疗（CT）组（n = 25）。IRAT组接受IRAT联合RFE治疗。RFE组仅接受RFE治疗。CT组接受传统治疗。干预每周进行5次，共4周。主要结局指标是上肢运动功能，采用上肢Fugl-Meyer评估量表（FMA-UE）进行评估。评估工具包括IRAT系统提供的其他测量指标，包括运动到达范围（KRR）、主动参与比例（APP）、轨迹偏差（TD）和轨迹跟踪误差（TTE）。
结果
三组间人口统计学特征差异无统计学意义（p > 0.05）。在基线时，各组间差异无统计学意义（p > 0.05）。所有组的FMA-UE、KRR和APP均显著增加（p < 0.05）。所有组的TD和TTE均显著降低（p < 0.05）。干预后，IRAT组的FMA-UE、KRR和APP评分显著高于RFE组和CT组。此外，IRAT组的TD和TTE显著低于RFE组和CT组。
结论
中风后，IRAT联合RFE在改善上肢运动功能方面比RFE或CT更有效。
试验注册
本研究已在https://www.CLINICALTRIALS.gov/（NCT06435624；2024年5月24日）注册。
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