Robot Training of Upper Limb in Multiple Sclerosis: Comparing Protocols With or WithoutManipulative Task Components
Robot Training of Upper Limb in Multiple Sclerosis: Comparing Protocols With or WithoutManipulative Task Components
复制标题
DOI：
10.1109/tnsre.2012.2187462
复制
发表时间：
2012-05-01
影响因子：
4.9
通讯作者：
Ferrarin, Maurizio
中科院分区：
文献类型：
--
作者：
Carpinella, Ilaria;Cattaneo, Davide;Ferrarin, Maurizio
在这项初步研究中，我们比较了两个协议的机器人为基础的上肢康复多发性硬化症（MS）：协议涉及达到任务（RT）只需要手臂运输和协议需要对象的达到和操作（RMT）。22例MS受试者被分配到RT或RMT组。两个方案均包括8个疗程。在RT训练中，受试者将平面机器人操纵器的手柄朝向屏幕上显示的圆形目标移动。RMT方案要求患者通过移动配备有手柄的机器人臂来达到和操纵真实的物体，该手柄使手自由地进行远端任务。在这两次训练中，机器人都产生了阻力和扰动力。受试者进行了临床和仪器测试。结果证实，MS患者保持了适应机器人产生的力量的能力，并且运动学习的速度在各个阶段都有所增加。机器人治疗显著减少手臂震颤，改善手臂运动学和功能能力。与RT相比，RMT方案在涉及抓握的运动方面诱导了显著更大的改善（抓握ARAT分项评分的改善：RMT 77.4%，RT 29.5%，p=0.035），但不包括精确抓握。未来的研究需要评估更长时间的训练和使用机器人手柄是否会显着改善精细操作。
In this pilot study, we compared two protocols for robot-based rehabilitation of upper limb in multiple sclerosis (MS): a protocol involving reaching tasks (RT) requiring arm transport only and a protocol requiring both objects' reaching and manipulation (RMT). Twenty-two MS subjects were assigned to RT or RMT group. Both protocols consisted of eight sessions. During RT training, subjects moved the handle of a planar robotic manipulandum toward circular targets displayed on a screen. RMT protocol required patients to reach and manipulate real objects, by moving the robotic arm equipped with a handle which left the hand free for distal tasks. In both trainings, the robot generated resistive and perturbing forces. Subjects were evaluated with clinical and instrumental tests. The results confirmed that MS patients maintained the ability to adapt to the robot-generated forces and that the rate of motor learning increased across sessions. Robot-therapy significantly reduced arm tremor and improved arm kinematics and functional ability. Compared to RT, RMT protocol induced a significantly larger improvement in movements involving grasp (improvement in Grasp ARAT sub-score: RMT 77.4%, RT 29.5%, p=0.035) but not precision grip. Future studies are needed to evaluate if longer trainings and the use of robotic handles would significantly improve also fine manipulation.