Xiang-Qian Shi, Chun-Hang Eden Ti, Hsuan-Yu Lu, Cheng-Peng Hu, Di-Sheng Xie, Kai Yuan, Ho-Lam Heung, Thomas Wai-Hong Leung, Zheng Li, Raymond Kai-Yu Tong
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引用次数: 0
Abstract
Background: Intensive task-oriented training has shown promise in enhancing distal motor function among patients with chronic stroke. A personalized electromyography (EMG)-driven soft robotic hand was developed to assist task-oriented object-manipulation training effectively. Objective. To compare the effectiveness of task-oriented training using the EMG-driven soft robotic hand.
Methods: A single-blinded, randomized controlled trial was conducted with 34 chronic stroke survivors. The subjects were randomly assigned to the Hand Task (HT) group (n = 17) or the control (CON) group (n = 17). The HT group received 45 minutes of task-oriented training by manipulating small objects with the robotic hand for 20 sessions, while the CON group received 45 minutes of hand-functional exercises without objects using the same robot. Fugl-Meyer assessment (FMA-UE), Action Research Arm Test (ARAT), Modified Ashworth Score (MAS), Box and Block test (BBT), Maximum Grip Strength, and active range of motion (AROM) of fingers were assessed at baseline, after intervention, and 3 months follow-up. The muscle co-contraction index (CI) was analyzed to evaluate the session-by-session variation of upper limb EMG patterns.
Results: The HT group showed more significant improvement in FMA-UE (wrist/hand, shoulder/elbow) compared to the CON group (P < .05). At 3-month follow-up, the HT group demonstrated significant improvements in FMA-UE, ARAT, BBT, MAS (finger), and AROMs (P < .05). The HT group exhibited a more significant decrease in muscle co-contractions compared to the CON group (P < .05).
Conclusions: EMG-driven task-oriented training with the personalized soft robotic hand was a practical approach to improving motor function and muscle coordination.
Clinical trial registry name: Soft Robotic Hand System for Stroke Rehabilitation.
背景：以任务为导向的强化训练有望增强慢性中风患者的远端运动功能。研究人员开发了一种由肌电图（EMG）驱动的个性化软机械手，可有效辅助以任务为导向的物体操作训练。目的比较使用肌电图驱动的软机器手进行任务导向训练的效果：方法：对 34 名慢性中风幸存者进行了单盲随机对照试验。受试者被随机分配到手任务（HT）组（17 人）或对照（CON）组（17 人）。HT组接受45分钟的任务导向训练，使用机器人手操作小物件，共20次；CON组接受45分钟的手部功能训练，不使用相同的机器人手操作物件。分别在基线、干预后和随访 3 个月时对 Fugl-Meyer 评估（FMA-UE）、行动研究手臂测试（ARAT）、改良阿什沃斯评分（MAS）、箱形和块形测试（BBT）、最大握力和手指主动活动范围（AROM）进行评估。对肌肉共收缩指数（CI）进行了分析，以评估上肢肌电图模式的逐次变化：结果：与 CON 组相比，HT 组在 FMA-UE（腕部/手部、肩部/肘部）方面有更明显的改善（P P P P 结论：EMG 驱动的任务导向型训练对上肢肌电模式的改善更明显：使用个性化软机器手进行EMG驱动的任务导向训练是改善运动功能和肌肉协调的一种实用方法。临床试验登记名称：用于中风康复的软机器手系统。临床试验登记-url：https://clinicaltrials.gov/.Unique identifier：NCT03286309。
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