Does hand robotic rehabilitation improve motor function by rebalancing interhemispheric connectivity after chronic stroke? Encouraging data from a randomised-clinical-trial
Does hand robotic rehabilitation improve motor function by rebalancing interhemispheric connectivity after chronic stroke? Encouraging data from a randomised-clinical-trial
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DOI：
10.1016/j.clinph.2019.02.013
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发表时间：
2019-05-01
影响因子：
4.7
通讯作者：
Naro, Antonino
中科院分区：
文献类型：
--
作者：
Calabro, Rocco Salvatore;Accorinti, Maria;Naro, Antonino
目的：本研究的目的是评估的临床和神经生理学效果的强化机器人辅助手治疗相比，强化职业治疗在慢性恢复阶段后stroke.Methods：50例首次中风发生至少6个月前，被招募和随机分为两组。实验组接受Amadeo（TM）手训练（AHT），对照组接受职业治疗师指导的常规手训练（CHT）。两组均接受40次手部训练（分别为机器人和传统），每次45分钟，每周5次，连续8周。所有的参与者进行了临床和电生理评估（任务相关的连贯性，TRCoh，和短潜伏期传入抑制，SAL）在基线和完成后的training.Results：AHT组提出的改善，在这两个主要的结果（Fugl-Meyer评估的上肢和九孔桩测试）大于CHT（均P < 0.001）。这些结果被AHT组额顶TRCoh比CHT组更大的增加所证实（p < 0.001），两个半球的SAL之间的再平衡更大（p < 0.001）。结论：这些数据表明，与CHT组相比，AHT组感觉运动皮层之间的感觉运动可塑性和半球间抑制的重塑范围更广。这些结果为强化机器人辅助治疗对慢性卒中患者手功能恢复的治疗影响提供了神经生理学支持。(C)2019国际临床神经生理学联合会。Elsevier B. V.出版，保留所有权利。
Objective: The objective of this study was the evaluation of the clinical and neurophysiological effects of intensive robot-assisted hand therapy compared to intensive occupational therapy in the chronic recovery phase after stroke.Methods: 50 patients with a first-ever stroke occurred at least six months before, were enrolled and randomised into two groups. The experimental group was provided with the Amadeo (TM) hand training (AHT), whereas the control group underwent occupational therapist-guided conventional hand training (CHT). Both of the groups received 40 hand training sessions (robotic and conventional, respectively) of 45 min each, 5 times a week, for 8 consecutive weeks. All of the participants underwent a clinical and electrophysiological assessment (task-related coherence, TRCoh, and short-latency afferent inhibition, SAL) at baseline and after the completion of the training.Results: The AHT group presented improvements in both of the primary outcomes (Fugl-Meyer Assessment for of Upper Extremity and the Nine-Hole Peg Test) greater than CHT (both p < 0.001). These results were paralleled by a larger increase in the frontoparietal TRCoh in the AHT than in the CHT group (p < 0.001) and a greater rebalance between the SAL of both the hemispheres (p < 0.001).Conclusions: These data suggest a wider remodelling of sensorimotor plasticity and interhemispheric inhibition between sensorimotor cortices in the AHT compared to the CHT group.Significance: These results provide neurophysiological support for the therapeutic impact of intensive robot-assisted treatment on hand function recovery in individuals with chronic stroke. (C) 2019 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.