Air Muscle and Task Practice in Upper Limb Stroke Rehab

描述（由申请人提供）：提议的项目解决NIH PA-02-111中描述的中风患者的运动功能和生活质量问题。许多持续性中风患者不能有效地使用偏瘫的上肢。日常活动（如吃饭或穿衣）的行动能力有限，会对他们的生活质量产生不利影响，并危及独立性。在重复任务练习（RTP）中参与偏瘫肢体的康复技术可以改善中风患者的上肢功能和生活质量，但成本限制了可以使用这种治疗的患者数量。微处理器设计和功能的进步使得使用辅助装置作为RTP的辅助是可行的。一种创新的使用“空气肌肉”的辅助重复运动（ARM）装置已经开发出来，专门用于偏瘫上肢的康复。本研究的主要目的是收集试点数据，以评估使用ARM装置联合RTP改善脑卒中患者上肢运动功能和生活质量的临床有效性。20个亚急性（3到9个）。中风后)患者将随机分为三组：仅ARM组、仅RTP组或RTP + ARM组。ARM组每天使用ARM 4小时，持续15天。RTP组将接受15天（每天4小时）的一对一强化RTP治疗。ARM + RTP组每天使用ARM设备2小时，每天接受2小时强化RTP，持续15天。在干预前后和两个月后进行临床运动功能和生活质量测量。我们假设ARM + RTP组将比ARM或RTP组在运动功能和生活质量方面表现出更大的改善。

DESCRIPTION (provided by applicant): The proposed project addresses the issues of motor function and quality of life in patients with stroke as described in NIH PA-02-111. Many patients who have sustained strokes are unable to effectively use their hemiparetic upper extremity. Limited mobility in the performance of daily activities, such as eating or dressing, adversely affects their quality of life and compromises independence. Rehabilitation techniques engaging the hemiparetic limb in repetitive task practice (RTP) may improve upper extremity function and quality of life in patients with stroke, but costs limit the number of patients that can utilize this type of therapy. Advances in microprocessor design and function make the use of an assistive device as an adjunct to RTP plausible. An innovative assistive repetitive motion (ARM) device using an "air muscle" has been developed specifically for the rehabilitation of the hemiparetic upper extremity. The primary aim of the proposed study is to collect pilot data to estimate the clinical effectiveness of using the ARM device in conjunction with RTP to improve upper extremity motor function and the quality of life of patients with stroke. Twenty sub-acute (3 to 9 mos. post-stoke) patients will be randomized to one of three groups: ARM only, RTP only or RTP + ARM group. The ARM group will use the ARM for four hours per day for 15 days. The RTP group will receive 15 days (4 hours per day) of intensive one-on-one RTP therapy. The ARM + RTP group will use the ARM device for 2 hours per day and receive 2 hours of intensive RTP per day for 15 days. Clinical motor function and quality of life measures will be taken before and after the interventions and two months later. We hypothesize that the ARM + RTP group will exhibit greater improvements in motor function and quality of life measures than the ARM or RTP only groups. Gathering quantitative motor (kinematic and kinetic) and imaging (fMRI) data from a subset of patients in each group to examine potential mechanisms contributing to improved motor function constitute unique addenda to this study. The results from this project will provide valuable data as a pre-requisite for submission of a multi-year R01 randomized clinical trial to determine the efficacy of using an assistive device, such as the ARM, as an adjunct to RTP. This project has the potential to increase the availability of effective rehabilitation techniques to patients with stroke.