Effects of Robot-Assisted Rehabilitation on Hand Function of People With Stroke: A Randomized, Crossover-Controlled, Assessor-Blinded Study
Effects of Robot-Assisted Rehabilitation on Hand Function of People With Stroke: A Randomized, Crossover-Controlled, Assessor-Blinded Study
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DOI：
10.5014/ajot.2021.038232
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发表时间：
2021-01-01
影响因子：
2.9
通讯作者：
Huang, Shih-Wei
中科院分区：
文献类型：
--
作者：
Lee, Hsin-Chieh;Kuo, Fen-Ling;Huang, Shih-Wei
目的：观察Gloreha机器人辅助治疗对中风患者感觉运动和手功能及日常生活活动能力的影响。设计：随机、交叉对照、盲法研究。研究对象：康复临床。参与者：中度运动和感觉障碍患者(N=24)。干预：患者参加12次RT和12次常规治疗(CT)，按顺序平衡，共6周。结果与测量：共评估了4次：放疗前、放疗后、放疗前、放疗后。采用Fugl-Meyer上肢功能评估(FMA-UE)、Box and Block测试、指总伸肌(EDC)和腕尺肌肌电图、运动功能握力测力仪、Semmes-Weinstein手部单丝和修订的Nottingham感觉功能评估以及ADL能力的改良Barthel指数(MBI)进行评估。结果：放疗后FMA-UE近端(p=.038)、总(p=.046)和MBI(p=.030)评分显著改善。受试者在放疗后盒块测试的小块抓握任务中，EDC肌肉表现出比CT后更高的效率(p=.050)。结论和相关性：Gloreha装置的RT可以促进全肢功能，对亚急性和慢性中风患者的手臂运动功能、EDC肌肉招募效能和ADL能力都有有益的影响。本文补充：证据表明，以任务为导向的方法结合Gloreha装置可以促进全肢主动运动，有效地促进功能恢复。
Importance: The effects of robot-assisted task-oriented training with tangible objects among patients with stroke remain unknown.Objective: To investigate the effects of robot-assisted therapy (RT) with a Gloreha device on sensorimotor and hand function and ability to perform activities of daily living (ADLs) among patients with stroke.Design: Randomized, crossover-controlled, assessor-blinded study.Setting: Rehabilitation clinic.Participants: Patients (N = 24) with moderate motor and sensory deficits.Intervention: Patients participated in 12 RT sessions and 12 conventional therapy (CT) sessions, with order counterbalanced, for 6 wk, with a 1-mo washout period.Outcomes and Measures: Performance was assessed four times: before and after RT and before and after CT. Outcomes were measured using the Fugl-Meyer Assessment-Upper Extremity (FMA-UE), Box and Block Test, electromyography of the extensor digitorum communis (EDC) and brachioradialis, and a grip dynamometer for motor function; Semmes-Weinstein hand monofilament and the Revised Nottingham Sensory Assessment for sensory function; and the Modified Barthel Index (MBI) for ADL ability.Results: RT resulted in significantly improved FMA-UE proximal (p =.038) and total (p =.046) and MBI (p =.030) scores. Participants' EDC muscles exhibited higher efficacy during the small-block grasping task of the Box and Block Test after RT than after CT (p =.050).Conclusions and Relevance: RT with the Gloreha device can facilitate whole-limb function, leading to beneficial effects on arm motor function, EDC muscle recruitment efficacy, and ADL ability for people with subacute and chronic stroke.What This Article Adds: The evidence suggests that a task-oriented approach combined with the Gloreha device can facilitate engagement in whole-limb active movement and efficiently promote functional recovery.