上肢机器人辅助疗法对恢复期脑卒中患者上肢运动功能及日常生活活动能力的效果

doi:10.3969/j.issn.1006-9771.2016.12.001

Abstract

Abstract: Objective To explore the effects of upper limb robot-assisted therapy on motor function and activities of daily living in convalescent stroke patients.Methods From June to September, 2016, 12 chronic stroke patients at their first-ever stroke were enrolled and randomized into experimental group (n=6) and control group (n=6). Both groups received routine rehabilitation. Additional robot-assisted therapy was provided to the experimental group, and additional repetitive movement training was provided to the control group, 20 minutes a day, five days a week for four weeks. Fugl-Meyer Assessment-Upper Extremities (FMA-UE), modified Ashworth Scale (MAS) and Functional Independent Measure (FIM) were used to assess the motor function of the upper limbs and hands, the muscular tension of shoulder and elbow, and activities of daily living (ADL) before and after treatment.Results After treatment, the scores of FMA-UE and FIM were better in both groups (Z>2.032, P<0.05), and no significant difference was found between two groups (t<0.723, P>0.05), however, the scores were a little bit higher in the experimental group than in the control group. After treatment, for the experimental group, the MAS scores of shoulder abduction/adduction and elbow flexion/extension improved (Z>2.121, P<0.05); for the control group, the MAS scores of shoulder abduction/adduction improved (Z>2.000, P<0.05), but the MAS scores of elbow flexion/extension were not significantly different (Z<1.890, P>0.05). There was no significant difference in the MAS scores of shoulder abduction/adduction and elbow flexion/extension between two group (Z<1.734, P>0.05). The moving trail recorded by the computer, gradually became a regular pattern from the mass, saying the motor control ability became better.Conclusion Upper limb robot-assisted therapy can promote the recovery of the motor function of upper limbs and ADL in convalescent stroke patient, similar to the repetitive movement training.

Key words: stroke, upper limb, robotics, repetitive movement training, rehabilitation, motor function, activities of daily living

CLC Number:

R743.3

ZHANG Chao, LIU Xuan, HOU Zeng-guang, PENG Long, YANG Hao, PENG Liang, ZHANG Hao,b, HONG Yi,c. Effects of Upper Limb Robot-assisted Therapy on Motor Function and Activities of Daily Living in Patients with Convalescent Stroke　[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2016, 22(12): 1365-1364.

References

[1] Sarti C, Rastenyte D, Cepaitis Z, et al. International trends in mortality from stroke, 1968 to 1994 [J]. Stroke, 2000, 31(7): 1588-1601.
[2] Mayo NE, Wood-Dauphinee S, Ahmed S, et al. Disablement following stroke [J]. Disabl Rehabli, 1999, 21(5-6): 258-268.
[3] 江晓峰,胡雪艳,熊国星,等. 社区脑卒中康复适宜技术对脑卒中患者社会功能活动的影响[J]. 中国康复理论与实践, 2011, 17(2): 178-180.
[4] French B, Thomas LH, Leathley MJ, et al. Repetitive task training for improving functional ability after stroke [J]. Cochrane Database Syst Rev, 2007(4): CD006073.
[5] Diserens K, Perret N, Chatemain S, et al. The effect of repetitive are cycling on post stroke spasticity and motor control: repetitive arm cy- cling and spasticity [J]. J Neurol Set, 2007, 253(1-2): 18-24.
[6] Van Peppen RP, Kwakkel G, Wood-Dauphinee S, et al. The impact of physical therapy on functional outcomes after stroke: what's the evidence? [J]. Clin Rehabil, 2004, 18(8): 833-862.
[7] Kwakkel G, Kollen B, Lindeman E. Understanding the pattern of functional recovery after stroke: facts and theories [J]. Restor Neurol Neurosci, 2004, 22(3-5): 281-299.
[8] Norouzi- Gheidari N, Archambault PS, Fung J. Effects of robot- assisted therapy on stroke rehabilitation in upper limbs: systematic review and meta-analysis of the literature [J]. J Rehabil Res Dev, 2012, 49(4): 479-496.
[9] Klamroth-Marganska V, Blanco J, Campen K, et al. Three-dimensional, task-specific robot therapy of the arm after stroke: a multicentre, parallel-group randomised trial [J]. Lancet Neurol, 2014, 13(2): 159-166.
[10] Masiero S, Armani M, Ferlini G, et al. Randomized trial of a robotic assistive device for the upper extremity during early inpatient stroke rehabilitation [J]. Neurorehabil Neural Repair, 2014, 28(4): 377-386.
[11] 全国第四届脑血管病学术会议. 各类脑血管病诊断要点[J]. 中华神经科杂志, 1996, 29(6): 379-380.
[12] Dobkin BH. Strategies for stroke rehabilitation [J]. Lancet Neurol, 2004, 3(9): 528-536.
[13] Cooke EV, Mares K, Clark A, et al. The effects of increased dose of exercise-based therapies to enhance motor recovery after stroke: a systematic review and meta-analysis [J]. BMC Med, 2010, 8: 60.
[14] Sivan M, O'Connor RJ, Makower S, et al. Systematic review of outcome measures used in the evaluation of robot-assisted upper limb exercise in stroke [J]. J Rehabil Med, 2011, 43(3): 181-189.
[15] 孙莹,花佳佳,施加加,等. 运动反馈训练对偏瘫患者上肢运动功能和日常生活活动能力的疗效[J]. 中国康复, 2015, 30(6): 409-411.
[16] 何斌,张超,刘璇. 上肢机器人辅助疗法对急性期脑卒中患者上肢运动功能的效果[J]. 中国康复理论与实践, 2016, 22(6): 688-692.
[17] Liao WW, Wu CY, Hsieh YW, et al. Effects of robot-assisted upper limb rehabilitation on daily function and real-world arm activity in patients with chronic stroke: a randomized controlled trial [J]. Clin Rehabil, 2012, 26(2): 111-120.
[18] Kwakkel G, Kollen BJ, Krebs HI. Effects of robot- assisted therapy on upper limb recovery after stroke: a systematic review [J]. Neurorehabil Neural Repair, 2008, 22(2): 111-121.
[19] Nudo RJ. Recovery after damage to motor cortical areas [J]. Curr Opin Neurobiol, 1999, 6: 740-747.
[20] Levin MF, Kleim JA, Wolf SL. What do motor "recovery" and "compensation" mean in patients following stroke? [J]. Neurorehabil Neural Repair, 2009, 23(4): 313-319.
[21] McDowd JM, Filion DL, Pohl PS, et al. Attentional abilities and functional outcomes following stroke [J]. J Gerontol B Psychol Sci Soc Sci, 2003, 58(1): 45-53.
[22] Iehikawa A, Yamamoto H, Ono I, et al. Stimulus- related 20-Hz activity of human cortex modulated by the way of presenting hand actions [J]. Neurosci Res, 2007, 58(3): 285-290.
[23] Stein J. Robotics in rehabilitation: Technology as destiny [J]. Am J Phys Med Rehab, 2012, 91(11): 199-203.
[24] Cauraugh JH, Summers JJ. Neural plasticity and bilateral movements: a rehabilitation approach for chronic stroke [J]. Prog Neurobiol, 2005, 75(5): 309-320.
[25] Burgar CG, Lum PS, Scremin AM, et al. Robot-assisted upper-limb therapy in acute rehabilitation setting following stroke: Department of Veterans Affairs multisite clinical trial [J]. J Rehabil Res Dev, 2011, 48(4): 445-458.

Effects of Upper Limb Robot-assisted Therapy on Motor Function and Activities of Daily Living in Patients with Convalescent Stroke

PDF (PC)

Knowledge

Abstract

Cite this article

share this article

References

Related Articles 15

Metrics

Comments

Recommended 0

[1]	LUO Lihua, WANG Yusheng, LI Jianfeng, DONG Jige. Effect of early postoperative comprehensive rehabilitation on children and youth with supracondylar fracture of humerus complicated with ulnar nerve injury [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2024, 30(1): 105-110.
[2]	WANG Zihao, LI Xinhua, JIANG Huiping, GUO Sainan, LIANG Qiuman, SHI Tingqi. Short-term knee function after total knee arthroplasty and related factors [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2024, 30(1): 111-118.
[3]	LIN Na, GAO Hanlu, LU Huiping, CHEN Yanqing, ZHENG Junfan, CHEN Shurong. Effect of virtual reality on upper limb function after stroke: a study of diffusion tensor imaging [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2024, 30(1): 61-67.
[4]	WANG Haoyi, SHI Yawei, LU Jun, XU Guangxu. Impact of subjective vertical perception impairment on function in stroke patients: a retrospective study [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2024, 30(1): 68-73.
[5]	CHEN Junwen, CHEN Qian, CHEN Cheng, LI Shuyue, LIU Lingling, WU Cunshu, GONG Xiang, LU Jun, XU Guangxu. Effect of modified Baduanjin exercise on cardiopulmonary function, motor function and activities of daily living for stroke patients [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2024, 30(1): 74-80.
[6]	HU Yonglin, MA Ying, DOU Chao, LU Anmin, JIANG Xiaoge, SONG Xinjian, XIAO Yuhua. Effect of neural mobilization based on shoulder control training on shoulder pain and upper limb function in stroke patients with hemiplegia [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2024, 30(1): 81-86.
[7]	WANG He, HAN Liang, KAN Mengfan, YU Shaohong. Efficacy of electrical stimulation on shoulder-hand syndrome after stroke: a systematic review and meta-analysis [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(9): 1048-1056.
[8]	SHI Jiawei, LI Lingyu, YANG Haojie, WANG Qinlu, ZOU Haiou. Effect of preoperative prerehabilitation training on total knee arthroplasty: a systematic review of systematic reviews [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(9): 1057-1064.
[9]	CAI Huanian, FEI Sixian, ZHANG Yichen, SUN Qing, GUO Shuai, SONG Tao. Motion assistance analysis for robot-assisted tele-rehabilitation based on bilateral admittance control [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(9): 1104-1109.
[10]	SUN Tengfang, REN Mengting, YANG Lin, WANG Yaoting, WANG Hongyu, YAN Xingzhou. Effect of hyperbaric oxygen therapy combined with repetitive peripheral magnetic stimulation on ankle motor function and balance of stroke patients [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(8): 875-881.
[11]	WANG Ya'nan, LIU Xihua. Correlation and predictive effect of subjective and objective balance function measurements in stroke patients with hemiplegia [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(8): 890-895.
[12]	WANG Haiyun, WANG Yin, ZHOU Xinjie, HE Aiqun. Effect of transcranial direct current stimulation combined with acupuncture on central and upper limb function in stroke patients based on central-peripheral-central theory [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(8): 919-925.
[13]	CHEN Yiting, WANG Qian, CUI Shenhong, LI Yingcai, ZHANG Siyu, WEI Yanxu, REN Hui, LENG Jun, CHEN Bin. Effect of bilateral sequential repetitive transcranial magnetic stimulation on motor function of upper limbs in stroke patients [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(8): 926-932.
[14]	LI Zhenya, SUN Jie, GUO Pengfei, WANG Guangming. Correlation between changes of swallowing function in oral and pharyngeal phases, and aspiration in stroke patients based on videofluroscopic swallowing study [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(8): 933-939.
[15]	LIU Yang, ZHANG Peng, HUANG Ying, CHEN Han, XU Chen, LI Min. Path analysis of mediating effect of perceived stress affecting impact of event in rehabilitation patients with traumatic injury [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(8): 954-960.