Post-traumatic hand rehabilitation using a powered metacarpal-phalangeal exoskeleton: a pilot study.

IF 5.2 2区 医学 Q1 ENGINEERING, BIOMEDICAL
Emanuele Peperoni, Emilio Trigili, Eugenio Capotorti, Stefano Laszlo Capitani, Tommaso Fiumalbi, Foebe Pettinelli, Sara Grandi, Alberto Rapalli, Giulia Lentini, Ilaria Creatini, Nicola Vitiello, Elisa Taglione, Simona Crea
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引用次数: 0

Abstract

Background: In the context of post-traumatic hand rehabilitation, stiffness of the hand joints limits the range of motion (ROM), grip strength, and the possibility of performing simple grasps. Robotic rehabilitation has been widely adopted for hand treatment with neurological patients, but its application in the orthopaedic scenario remains limited. In this paper, a pilot study targeting this population is presented, where the rehabilitation is performed using a powered finger exoskeleton, namely I-Phlex. The device aims to mobilize the metacarpal-phalangeal joint (MCP) in flexion-extension movements. The objective of the study was to verify the short-term efficacy, experience of use, and safety of I-Phlex in a clinical setting. As a secondary objective, the study verified the device's capability to measure clinically relevant variables.

Methods: Six subjects with trauma-related illnesses of the right hand took part in the experiment. Passive and active range of motion (PROM and AROM) were recorded at the beginning and the end of the session by the therapist and by the exoskeleton. Experience of use was assessed through ad-hoc questionnaires and a numerical pain rate scale (NPRS). Safety was assessed by computing the number of adverse events during the operation.

Results: Median increases in the PROM and AROM of 5.88% and 11.11% respectively were recorded among subjects. The questionnaires reported a median score of 93.83; IQR (85.01-100) and 80.00; IQR (79.79-93.75) respectively. No increase in the median NPRS was recorded among subjects between pre-and post-treatment. No major adverse event or injury to the patients was recorded. Only one malfunction was reported due to the brake of a transmission cable, but the patient reported no injury or discomfort. No statistical significance was observed between the ROM measurement recorded using the exoskeleton and the ones taken by the therapist using the goniometer.

Conclusions: The device and related rehabilitation exercises can be successfully used in the clinical rehabilitation of the MCP joint. The device measurements are in line with the goniometer assessment from the therapist. Future studies will aim to reinforce the results obtained, introducing a control group to conclude on the specific contribution of the technology compared to conventional therapy.

Trial registration: Hand Motor Rehabilitation Using a Wearable Robotic Device (WRL HX MCP), Clinicaltrials.gov ID NCT05155670, Registration date 13 December 2021, URL https://clinicaltrials.gov/ct2/show/NCT05155670 .

创伤后手部康复使用动力掌指骨外骨骼:一项试点研究。
背景:在创伤后手部康复的背景下,手部关节的僵硬限制了运动范围(ROM)、握力和进行简单握力的可能性。机器人康复已被广泛应用于神经系统患者的手部治疗,但其在骨科领域的应用仍然有限。在本文中,提出了一项针对这一人群的试点研究,其中使用动力手指外骨骼进行康复,即I-Phlex。该装置的目的是在屈伸运动中调动掌指关节(MCP)。该研究的目的是验证I-Phlex在临床环境中的短期疗效、使用体验和安全性。作为次要目标,该研究验证了该设备测量临床相关变量的能力。方法:选取6例右手创伤性疾病患者作为实验对象。在治疗开始和结束时,由治疗师和外骨骼记录被动和主动活动范围(PROM和AROM)。通过特设问卷和数值疼痛率量表(NPRS)评估使用经验。通过计算手术过程中不良事件的数量来评估安全性。结果:受试者的PROM和AROM中位数分别增加5.88%和11.11%。问卷的中位得分为93.83;IQR(85.01-100)和80.00;IQR分别为79.79-93.75。治疗前后受试者的NPRS中位数没有增加。患者无重大不良事件或损伤记录。只有一个故障报告是由于传输电缆的刹车,但病人报告没有受伤或不适。使用外骨骼记录的ROM测量与治疗师使用角计测量的ROM测量之间没有统计学意义。结论:该装置及相关康复训练可成功用于MCP关节的临床康复。设备测量值与治疗师的测角仪评估值一致。未来的研究将旨在加强所获得的结果,引入一个对照组,以总结该技术与传统疗法相比的具体贡献。试验注册:使用可穿戴机器人设备的手部运动康复(WRL HX MCP), Clinicaltrials.gov ID NCT05155670,注册日期2021年12月13日,URL https://clinicaltrials.gov/ct2/show/NCT05155670。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of NeuroEngineering and Rehabilitation
Journal of NeuroEngineering and Rehabilitation 工程技术-工程:生物医学
CiteScore
9.60
自引率
3.90%
发文量
122
审稿时长
24 months
期刊介绍: Journal of NeuroEngineering and Rehabilitation considers manuscripts on all aspects of research that result from cross-fertilization of the fields of neuroscience, biomedical engineering, and physical medicine & rehabilitation.
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