Upper limb robot-assisted rehabilitation versus physical therapy on subacute stroke patients: A follow-up study
Upper limb robot-assisted rehabilitation versus physical therapy on subacute stroke patients: A follow-up study
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DOI：
10.1016/j.jbmt.2019.03.016
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发表时间：
2020-01-01
影响因子：
1.4
通讯作者：
Posteraro, Federico
中科院分区：
文献类型：
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作者：
Franceschini, Marco;Mazzoleni, Stefano;Posteraro, Federico
本研究旨在分析亚急性脑卒中患者上肢机器人辅助治疗（RT）与传统物理治疗（TT）的长期效果（6个月随访）。虽然关于机器人上肢康复的文献显示了越来越多的证据表明其对中风幸存者的有效性，但重新学习的运动能力可以保持的时间长度仍然没有得到充分研究。对48例亚急性脑卒中患者进行随机对照随访研究，这些患者使用平面末端执行器机器人系统（实验组-EG）或TT（对照组-CG）进行上肢治疗。在T0（基线）、T1（治疗结束）和T2（6个月随访）时收集临床评估：Fugl-Meyer评估的上肢部分（FM-UL）、总被动活动度（pROM）、改良Ashworth肩关节量表（MAS-S）和肘关节量表（MAS-E）。在T1时，组内分析显示EG和CG的FM-UL均显著增加，而仅在EG中发现MAS-S、MAS-E和pROM显著改善。在T2，仅在CG中显示MASS显著增加。在两组的FM-UL、pROM和MAS-E中，治疗结束时获得的改善似乎在6个月随访时得以维持。T1和T2时FM-UL值的组间分析表明，EG组间差异显著。总之，与传统治疗相比，上肢机器人辅助治疗可能会更大程度地减少亚急性卒中患者的运动障碍。治疗结束时观察到的获益随时间持续。未发生与研究相关的严重不良事件。(C)2019爱思唯尔有限公司版权所有。
This study aims to analyse the long-term effects (6 months follow-up) of upper limb Robot-assisted Therapy (RT) compared to Traditional physical Therapy (TT), in subacute stroke patients. Although the literature on upper-limb rehabilitation with robots shows increasing evidence of its effectiveness in stroke survivors, the length of time for which the re-learned motor abilities could be maintained is still understudied. A randomized controlled follow-up study was conducted on 48 subacute stroke patients who performed the upper-limb therapy using a planar end-effector robotic system (Experimental Group-EG) or TT (Control Group-CG). The clinical assessments were collected at T0 (baseline), T1 (end of treatment) and T2 (6 months follow-up): Upper Limb part of Fugl-Meyer assessment (FM-UL), total passive Range Of Motion (pROM), Modified Ashworth Scale Shoulder (MAS-S) and Elbow (MAS-E). At T1, the intra-group analysis showed significant gain of FM-UL in both EG and CG, while significant improvement in MAS-S, MAS-E, and pROM were found in the EG only. At T2, significant increase in MASS were revealed only in the CG. In FM-UL, pROM and MAS-E the improvements obtained at the end of treatment seem to be maintained at 6 months follow-up in both groups. The inter-groups analysis of FM-UL values at T1 and T2 demonstrated significant differences in favour of EG. In conclusion, upper limb Robot-assisted Therapy may lead a greater reduction of motor impairment in subacute stroke patients compared to Traditional Therapy. The gains observed at the end of treatment persisted over time. No serious adverse events related to the study occurred. (C) 2019 Elsevier Ltd. All rights reserved.