Air Muscle and Task Practice in Upper Limb Stroke Rehab

上肢中风康复中的空气肌和任务练习

• 批准号: 7162451
• 负责人: JAY L. ALBERTS
• 金额: $ 21.21万
• 依托单位: CLEVELAND CLINIC LERNER COM-CWRU
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-09-01 至 2008-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7162451
• 关键词: assistive device /technology; behavioral /social science research tag; biomechanics; clinical research; combination therapy; functional ability; functional magnetic resonance imaging; human subject; human therapy evaluation; limb movement; medical rehabilitation related tag; motor cortex; muscle function; neurophysiology; patient oriented research; quality of life; stroke therapy

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.

描述(由申请人提供)：建议的项目解决了NIH PA-02-111中所描述的中风患者的运动功能和生活质量问题。许多持续中风的患者无法有效地使用偏瘫的上肢。在日常活动中行动不便，如吃饭或穿衣，会对他们的生活质量产生不利影响，并损害他们的独立性。使用偏瘫肢体进行重复任务练习(RTP)的康复技术可能会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设备作为RTP的附件是可能的。一种创新的辅助重复运动(ARM)装置已经被开发出来，专门用于偏瘫上肢的康复。这项拟议研究的主要目的是收集试点数据，以评估ARM设备与RTP联合使用改善中风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至9个月卒中后)患者将被随机分为三组：仅ARM组、RTP组或RTP+ARM组。ARM组将在15天内每天使用ARM 4小时。RTP组将接受15天(每天4小时)的强化一对一RTP治疗。ARM+RTP组每天使用ARM设备2小时，并在15天内每天接受2小时的高强度RTP。干预前后及干预后2个月分别进行临床运动功能和生活质量检查。我们假设，ARM+RTP组在运动功能和生活质量测量方面将比ARM或RTP组表现出更大的改善。 从每组患者中收集定量的运动(运动学和运动学)和成像(FMRI)数据，以检查有助于改善运动功能的潜在机制，构成了这项研究的独特补充。该项目的结果将提供有价值的数据，作为提交多年R01随机临床试验的先决条件，以确定使用辅助设备(如ARM)作为RTP辅助设备的有效性。该项目有可能为中风患者提供更多有效的康复技术。