Early Stroke Rehabilitation of the Upper Limb Assisted with an Electromyography-Driven Neuromuscular Electrical Stimulation-Robotic Arm.
Early Stroke Rehabilitation of the Upper Limb Assisted with an Electromyography-Driven Neuromuscular Electrical Stimulation-Robotic Arm.
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DOI：
10.3389/fneur.2017.00447
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发表时间：
2017
影响因子：
3.4
通讯作者：
Poon W
中科院分区：
文献类型：
--
作者：
Qian Q;Hu X;Lai Q;Ng SC;Zheng Y;Poon W
有效的中风后运动康复取决于自愿努力的反复肢体练习。肌电图（EMG）驱动的神经肌肉电刺激（NMES）机器人手臂被设计用于肘部、手腕和手指的多关节物理训练。调查设备辅助方法对亚急性中风患者的训练效果，并将其与传统物理治疗的效果进行比较。该研究是一项随机对照试验，随访期为 3 个月。亚急性卒中参与者被随机分为两组，然后接受肌电图驱动的 NMES 机械臂（NMES 机器人组，n = 14）或时间匹配的传统疗法（对照组，n = 10）进行 20 节上肢训练。为了评估训练效果，在康复训练前、训练后和训练后3个月进行临床评估，包括Fugl-Meyer评估（FMA）、改良Ashworth评分（MAS）、行动研究手臂测试（ARAT）和功能独立测量（FIM）。 NMES 机器人组中的逐次肌电图参数，包括标准化协同收缩指数 (CI) 和目标肌肉的肌电图激活水平，用于监测肌肉协调模式的进展。两组的 FMA（满分和肩/肘）、ARAT 和 FIM 均获得显着改善 [P < 0.001，效应量 (EFs) > 0.279]。治疗后，仅在 NMES 机器人组中观察到 FMA 手腕/手部显着改善（P<<0.001，EFs=<0.435）。训练后，NMES机器人组观察到MAS手腕显着减少（P<0.05，EFs=0.145），并且效果维持3个月。对照组的MAS评分在训练后有所上升（P < 0.05，EFs > 0.24），并且在3个月后评估时仍保持在较高水平。肌电图参数表明 NMES 机器人组中肱二头肌和桡侧腕屈肌以及肱二头肌和肱三头肌的肌肉协同收缩得到释放，腕屈肌的肌肉激活水平降低。 NMES机器人辅助训练对于早期中风上肢康复非常有效，并且与传统的物理治疗相比，可以提高日常生活的独立性。与传统疗法相比，它可以在远端关节处实现更高的运动效果，并更有效地释放肌肉张力。 ，标识符NCT02117089；注册日期：2014年4月10日。
Effective poststroke motor rehabilitation depends on repeated limb practice with voluntary efforts. An electromyography (EMG)-driven neuromuscular electrical stimulation (NMES)-robot arm was designed for the multi-joint physical training on the elbow, the wrist, and the fingers. To investigate the training effects of the device-assisted approach on subacute stroke patients and to compare the effects with those achieved by the traditional physical treatments. This study was a pilot randomized controlled trial with a 3-month follow-up. Subacute stroke participants were randomly assigned into two groups, and then received 20-session upper limb training with the EMG-driven NMES-robotic arm (NMES-robot group, n = 14) or the time-matched traditional therapy (the control, n = 10). For the evaluation of the training effects, clinical assessments including Fugl-Meyer Assessment (FMA), Modified Ashworth Score (MAS), Action Research Arm Test (ARAT), and Function Independence Measurement (FIM) were conducted before, after the rehabilitation training, and 3 months later. Session-by-session EMG parameters in the NMES-robot group, including normalized co-contraction Indexes (CI) and EMG activation level of target muscles, were used to monitor the progress in muscular coordination patterns. Significant improvements were obtained in FMA (full score and shoulder/elbow), ARAT, and FIM [P < 0.001, effect sizes (EFs) > 0.279] for both groups. Significant improvement in FMA wrist/hand was only observed in the NMES-robot group (P < 0.001, EFs = 0.435) after the treatments. Significant reduction in MAS wrist was observed in the NMES-robot group after the training (P < 0.05, EFs = 0.145) and the effects were maintained for 3 months. MAS scores in the control group were elevated following training (P < 0.05, EFs > 0.24), and remained at an elevated level when assessed 3 months later. The EMG parameters indicated a release of muscle co-contraction in the muscle pairs of biceps brachii and flexor carpi radialis and biceps brachii and triceps brachii, as well as a reduction of muscle activation level in the wrist flexor in the NMES-robot group. The NMES-robot-assisted training was effective for early stroke upper limb rehabilitation and promoted independence in the daily living comparable to the traditional physical therapy. It could achieve higher motor outcomes at the distal joints and more effective release in muscle tones than the traditional therapy. , identifier NCT02117089; date of registration: April 10, 2014.
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影响因子：
2.6
作者：
Brauer SG;Hayward KS;Carson RG;Cresswell AG;Barker RN
通讯作者：
Barker RN
影响因子：
158.5
作者：
Dobkin, BH
通讯作者：
Dobkin, BH
影响因子：
1.4
作者：
Brown TM;Parmar G;Durant RW;Halanych JH;Hovater M;Muntner P;Prineas RJ;Roth DL;Samdarshi TE;Safford MM
通讯作者：
Safford MM
DOI：
10.1016/j.pmr.2015.06.002
发表时间：
2015-11
影响因子：
1.7
作者：
Knutson JS;Fu MJ;Sheffler LR;Chae J
通讯作者：
Chae J
影响因子：
2.5
作者：
Hu, X. L.;Tong, K. Y.;Au-Yeung, S. S. Y.
通讯作者：
Au-Yeung, S. S. Y.