Sensory Stimulation and Robot-Assisted Arm Training After Stroke: A Randomized Controlled Trial.

IF 2.6 3区医学 Q2 CLINICAL NEUROLOGY

Journal of Neurologic Physical Therapy Pub Date : 2024-10-01 Epub Date: 2024-09-17 DOI:10.1097/NPT.0000000000000486

Marion Egger, Jeannine Bergmann, Carmen Krewer, Klaus Jahn, Friedemann Müller

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引用次数: 0

Abstract

Background and purpose: Functional recovery after stroke is often limited, despite various treatment methods such as robot-assisted therapy. Repetitive sensory stimulation (RSS) might be a promising add-on therapy that is thought to directly drive plasticity processes. First positive effects on sensorimotor function have been shown. However, clinical studies are scarce, and the effect of RSS combined with robot-assisted training has not been evaluated yet. Therefore, our objective was to investigate the feasibility and sensorimotor effects of RSS (compared to a control group receiving sham stimulation) followed by robot-assisted arm therapy.

Methods: Forty participants in the subacute phase (4.4-23.9 weeks) after stroke with a moderate to severe arm paresis were randomized to RSS or control group. Participants received 12 sessions of (sham-) stimulation within 3 weeks. Stimulation of the fingertips and the robot-assisted therapy were each applied in 45-min sessions. Motor and sensory outcome assessments (e.g. Fugl-Meyer-Assessment, grip strength) were measured at baseline, post intervention and at a 3-week follow-up.

Results: Participants in both groups improved their sensorimotor function from baseline to post and follow-up measurements, as illustrated by most motor and sensory outcome assessments. However, no significant group effects were found for any measures at any time ( P > 0.058). Stimulations were well accepted, no safety issues arose.

Discussion and conclusions: Feasibility of robot-assisted therapy with preceding RSS in persons with moderate to severe paresis was demonstrated. However, RSS preceding robot-assisted training failed to show a preliminary effect compared to the control intervention. Participants might have been too severely affected to identify changes driven by the RSS, or these might have been diluted or more difficult to identify because of the additional robotic training and neurorehabilitation.

Video abstract available: for more insights from the authors (see the Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A478 ).

查看原文本刊更多论文

中风后的感官刺激和机器人辅助手臂训练：随机对照试验。

背景和目的：尽管有机器人辅助治疗等多种治疗方法，但中风后的功能恢复往往受到限制。重复感觉刺激（RSS）可能是一种很有前景的附加疗法，它被认为能直接推动可塑性过程。已有研究表明，该疗法对感觉运动功能有积极影响。然而，临床研究很少，而且尚未对 RSS 与机器人辅助训练相结合的效果进行评估。因此，我们的目标是调查 RSS（与接受假刺激的对照组相比）的可行性和感觉运动效果，然后再进行机器人辅助手臂治疗：方法：40 名中风后处于亚急性期（4.4-23.9 周）的中重度手臂瘫痪者被随机分配到 RSS 组或对照组。参与者在 3 周内接受了 12 次（假）刺激。指尖刺激和机器人辅助治疗各进行45分钟。在基线、干预后和3周的随访中对运动和感官结果（如福格尔-迈耶评估、握力）进行了测量：结果：从基线到干预后和随访测量，两组参与者的感官运动功能都有所改善，大多数运动和感官结果评估都表明了这一点。然而，在任何时间的任何测量中，都没有发现明显的组间效应（P > 0.058）。刺激被广泛接受，没有出现安全问题：中重度瘫痪患者在接受机器人辅助治疗前接受RSS治疗的可行性已得到证实。然而，与对照干预相比，机器人辅助训练前的RSS未能显示出初步效果。参与者可能受到了太严重的影响，无法识别RSS所带来的变化，或者由于额外的机器人训练和神经康复，这些变化可能被淡化或更难识别。视频摘要：如需了解作者的更多见解（请参阅视频，补充数字内容1，网址：http://links.lww.com/JNPT/A478）。

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来源期刊

Journal of Neurologic Physical Therapy CLINICAL NEUROLOGY-REHABILITATION

CiteScore

5.70

自引率

2.60%

发文量

审稿时长

>12 weeks

期刊介绍： The Journal of Neurologic Physical Therapy (JNPT) is an indexed resource for dissemination of research-based evidence related to neurologic physical therapy intervention. High standards of quality are maintained through a rigorous, double-blinded, peer-review process and adherence to standards recommended by the International Committee of Medical Journal Editors. With an international editorial board made up of preeminent researchers and clinicians, JNPT publishes articles of global relevance for examination, evaluation, prognosis, intervention, and outcomes for individuals with movement deficits due to neurologic conditions. Through systematic reviews, research articles, case studies, and clinical perspectives, JNPT promotes the integration of evidence into theory, education, research, and practice of neurologic physical therapy, spanning the continuum from pathophysiology to societal participation.