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Home therapy for upper limb stroke rehabilitation using the HandSOME exoskeleton

使用 HandSOME 外骨骼进行上肢中风康复的家庭治疗

基本信息

批准号：
9334268
负责人：
PETER S. LUM
金额：
$ 22.67万
依托单位：
CATHOLIC UNIVERSITY OF AMERICA
依托单位国家：
美国
项目类别：
财政年份：
2016
资助国家：
美国
起止时间：
2016-09-01 至 2019-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9334268
关键词：
Action Research Activities of Daily Living Articular Range of Motion Biomechanics Brachial Paresis Categories Clinic Visits Clinical Clinical Protocols Clinical Trials Data Devices Digit structure Educational Status Electronics Evaluation Exercise Extensor Fatigue Fingers Flexor Frustration Goals Hand Hand functions Home environment Impairment Individual Joints Monitor Motor Activity Movement Neurorehabilitation Outpatients Paresis Patients Pattern Pilot Projects Population Protocols documentation Randomized Controlled Trials Recruitment Activity Residual state Resistance Robotics Rotation Stroke Testing Therapeutic Therapeutic Intervention Thumb structure Training Treatment Protocols United States Upper Extremity Volition arm base chronic stroke clinically significant exoskeleton experience falls follow-up functional improvement grasp hand dysfunction hand rehabilitation improved indexing learning strategy light weight motor control motor learning movement practice negative affect novel prevent repetitive task practice restoration sensor stem stroke rehabilitation stroke survivor

项目摘要

There are 800,000 new strokes in the United States each year. Functional improvement of the upper paretic limb after stroke is mainly determined by improvement of the paretic hand, yet restoration of hand function after stroke often lags behind restoration of more proximal joints, and impairments are often resistant to therapeutic intervention. The rationale for our approach stems from the growing evidence that neuro-rehabilitation after stroke may be enhanced via the application of motor learning strategies within the context of repetitive movement practice. The key therapeutic aspects of these strategies are high repetition, volitional effort, and successful completion of tasks to prevent frustration. While these represent promising therapeutic strategies, they are limited to mildly impaired subjects who already have enough control of finger extension to tolerate high repetitions of grasp/release tasks without succumbing to fatigue and frustration. There is a very large population of stroke patients who don't fall into this category and often must rely on inefficient compensatory strategies. In these patients, unassisted repetitive task practice may not be the optimal retraining strategy. Previously we have developed HandSOME (Hand Spring Operated Movement Enabler), a passive exoskeleton that provides extension assistance during a simple grasp pattern. HandSOME is inexpensive, lightweight and can be donned independently by patients. Hand range-of-motion and function is increased immediately when wearing HandSOME and enables successful practice of reach and grasp tasks, even in subjects with severe hand impairment. The specific aims of this study are to make several protocol improvements based on our experiences from pilot testing to improve retention and evaluate this new protocol in a home training study with chronic stroke subjects.

美国每年有80万例新中风患者。功能