Objective To explore the effects of robot-assisted therapy combined with mirror therapy (MT) on upper limbs in patients with hemiplegia after stroke.Methods From January, 2017 to June, 2018, 56 patients with hemiplegia after stroke were randomly divided into control group (n = 28) and observation group (n = 28). The control group received conventional therapy, and the treatment group received robot-assisted therapy combined with MT, additionally. They were assessed with Fugl-Meyer Assessment-Upper Extremities (FMA-UE), Wolf Motor Function Test (WMFT), Functional Independence Measure (FIM) and modified Barthel Index (MBI) before and four weeks after treatment.Results Four weeks after treatment, the scores of FMA-UE, WMFT and MBI were better in both groups (t > 2.959, P < 0.05), and were better in the observation group than in the control group (t > 4.732, P < 0.001).Conclusion Robot-assisted therapy combined with MT could improve the function of upper limb and activities of daily living in patients with hemiplegia after stroke.
RONG Ji-feng
,
DING Li
,
ZHANG Wen
,
WANG Wei-ning
,
DENG Mei-kui
,
XIONG Li
,
JIA Jie
. Effects of Robot-assisted Therapy Combined with Mirror Therapy on Upper Limbs Rehabilitation in Patients with Hemiplegia after Stroke[J]. Chinese Journal of Rehabilitation Theory and Practice, 2019
, 25(6)
: 709
-713
.
DOI: 10.3969/j.issn.1006-9771.2019.06.016
1 FryerC E, LukerJ A, McDonnellM N, et al. Self management programmes for quality of life in people with stroke [J]. Cocharane DB Syst Rev, 2016, 8(8): CD010442.
2 ZengW, GuoY, WuG , et al. Mirror therapy for motor function of the upper extremity in patients with stroke: a meta-analysis [J]. J Rehabil Med, 2018, 50(1): 8-15.
3 GandolfiM, ValèN, DimitrovaE K, et al. Effects of high-intensity robot-assisted hand training on upper limb recovery and muscle activity in individuals with multiple sclerosis: a randomized, controlled, single-blinded trial [J]. Front Neurol, 2018, 9: 905.
4 AltschulerE L, WisdomS B, StoneL, et al. Rehabilitation of hemiparesis after stroke with a mirror [J]. Lancet, 1999, 353(9169): 2035-2036.
5 Pérez-CruzadoD, Merchán-BaezaJ A, González-SánchezM, et al. Systematic review of mirror therapy compared with conventional rehabilitation in upper extremity function in stroke survivors [J]. Aust Occup Ther J, 2017, 64: 91-112.
6 中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组. 中国重症脑血管病管理共识2015[J]. 中华神经科杂志, 2016, 49(3): 192-202.
7 Fugl-MeyerA R, JääsköL, LeymanI, et al. The post-stroke hemiplegic patient. 1. a method for evaluation of physical performance [J]. Scand J Rehabil Med, 1975, 7(1): 13-31.
8 WolfS, CatlinP, EllisM, et al. Assessing wolf motor function test as outcome measure for research in patients after stroke [J]. Stroke, 2001, 32(7): 1635-1639.
9 KiddD, StewartG, BaldryJ, et al. The Functional Independence Measure: a comparative validity and reliability study [J]. Disabil Rehabil, 1995, 17(1): 10-14.
10 MahoneyF I, BarthelD W. Functional evaluation: the Barthel Index [J]. Md State Med J, 1965, 14(1): 61-65.
11 周游飞,王德强,李红卫,等. 脑卒中后手部活动障碍的研究进展[J]. 中国康复, 2017, 32(2): 151-154.
12 梁天佳,吴小平,龙耀斌,等. 机器人辅助训练对脑卒中患者上肢功能恢复的影响及功能性磁共振分析[J]. 中华物理医学与康复杂志, 2014, 36(11): 844-846.
13 侯红,范亚蓓,吴玉霞,等. 康复机器人辅助训练对偏瘫患者上肢功能及日常生活活动能力的影响[J]. 中国康复医学杂志, 2015, 30(10): 1013-1016.
14 DebnathR, FranzE A. Perception of hand movement by mirror reflection evokes brain activation in the motor cortex contralateral to a non-moving hand [J]. Cortex, 2016, 81: 118-125.
15 FabianS, HenrikP N, MichaelD. Mirror visual feedback training improves intermanual transfer in a sport-specific task: a comparison between different skill levels [J]. Neural Plasticity, 2016, 2016(2): 1-11.
16 FadigaL, CraigheroL. Electrophysiology of action representation [J]. J Clin Neurophysiol, 2004, 21(3): 157-169.
17 BlefariM L, JamesS, Marie-ClaudeH R, et al. Improvement in precision grip force control with self-modulation of primary motor cortex during motor imagery [J]. Front Behav Neurosci, 2015, 9: 18.
18 SonY L, KimJ W. The effects of mirror neuron system-based self-observation training on lower limb muscle activity and dynamic balance in patients with chronic stroke [J]. J Phys Ther Sci, 2018, 30: 1241-1244.
19 KangY J, KuJ, KimH J, et al. Facilitation of corticospinal excitability according to motor imagery and mirror therapy in healthy subjects and stroke patients [J]. Ann Rehabil Med, 2011, 35: 747-758.
20 沈芳. 镜像疗法在脑卒中偏瘫患者上肢运动功能康复中应用的研究进展[J]. 中国康复医学杂志, 2016, 31(5): 590-593.
21 NedelkoV, HassaT, HamzeiF, et al. Age-independent activation in areas of the mirror neuron-system during action observation and action imagery: a fMRI study [J]. Restor Neurol Neurosei, 2010, 28: 737-747.
22 HamzeiF, VryM S, SaurD, et al. The dual-loop model and the human mirror neuron system: an exploratory combined fMRI and DTI study of the inferior frontal gyrus [J]. Cereb Cortex, 2016, 44(5): 18-44.
23 马玉静,勾丽洁,王文清. 镜像视觉反馈在脑卒中患者上肢功能障碍康复中的应用[J]. 中国康复医学杂志, 2016, 31(3): 358-362.
24 丁力,荣积峰,崔晓,等. 基于“闭环康复”的数字化镜像疗法对脑卒中患者上肢功能恢复的影响[J]. 华西医学, 2018, 33(10): 1-5.
25 MirelaC L, MateiD, IgnatB, et al. Mirror therapy enhances upper extremity motor recovery in stroke patients [J]. Acta Neurol Belg, 2015, 115: 597-603.
