Comparison of active-assisted and active-unassisted robot-mediated upper limb therapy in subacute stroke.

IF 1.9 4区医学 Q4 NEUROSCIENCES

Restorative neurology and neuroscience Pub Date : 2021-01-01 DOI:10.3233/RNN-201010

Ophélie Pila, Typhaine Koeppel, Anne-Gaëlle Grosmaire, Christophe Duret

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引用次数: 1

Abstract

Background: Upper-limb robot-mediated therapy is usually carried out in active-assisted mode because it enables performance of many movements. However, assistance may reduce the patient's own efforts which could limit motor recovery.

Objective: The aim of this study was to compare the effects of active-assisted and active-unassisted robotic interactions on motor recovery in subacute stroke patients with moderate hemiparesis.

Methods: Fourteen patients underwent a 6-week combined upper limb program of usual therapy and robotic therapy using either the active-unassisted (n = 8) or active-assisted (n = 6) modes. In the active-assisted group, assistance was only provided for the first 3 weeks (1st period) and was then switched off for the remaining 3 weeks (2nd period). The Fugl-Meyer Assessment (FMA) was carried out pre- and post-treatment. The mean number of movements performed and the mean working distance during the 1st and 2nd periods were compared between groups.

Results: FMA score improved post-treatment in both groups with no between-group differences: active-assisted group: +8±6 pts vs active-unassisted group: +10±6 pts (ns). Between the 1st and 2nd periods, there was a statistical trend towards an improvement in the number of movements performed (p = 0.06) in the active-unassisted group (526±253 to 783±434, p = 0.06) but not in the active-assisted group (882±211 to 880±297, ns). Another trend of improvement was found for the working distance in the active-unassisted group (8.7±4.5 to 9.9±4.7, p = 0.09) but not in the active-assisted group (14.0±0 to 13.5±1.1, ns).

Conclusions: The superiority of the non-assistive over assistive robotic modes has not been demonstrated. However, the non-assistive mode did not appear to reduce motor recovery in this population, despite the performance of fewer movements on shorter working distance compared with the group who had assistance. It seems that the requirement of effort could be a determinant factor for recovery in neurorehabilitation however further well-design studies are needed to fully understand this phenomenon.

查看原文本刊更多论文

主动辅助和主动非辅助机器人介导的上肢治疗在亚急性卒中中的比较。

背景:上肢机器人介导的治疗通常在主动辅助模式下进行，因为它可以完成许多动作。然而，辅助可能会减少患者自己的努力，从而限制运动恢复。目的:本研究的目的是比较主动辅助和主动无辅助机器人交互对中度偏瘫亚急性脑卒中患者运动恢复的影响。方法:14例患者采用主动-非辅助(n = 8)或主动-辅助(n = 6)模式，接受了为期6周的常规治疗和机器人治疗联合上肢方案。在主动辅助组中，仅在前3周(第一期)提供援助，然后在剩余的3周(第二期)停止提供援助。治疗前后分别进行Fugl-Meyer评估(FMA)。比较各组第1、2期平均运动次数和平均工作距离。结果:两组治疗后FMA评分均有改善，组间无差异:主动辅助组+8±6分vs主动无辅助组+10±6分(ns)。在第1期和第2期之间，主动辅助组的运动次数(526±253 ~ 783±434,p = 0.06)有统计学改善趋势(p = 0.06)，而主动辅助组的运动次数(882±211 ~ 880±297,ns)无统计学改善趋势(p = 0.06)。主动-无辅助组工作距离有改善趋势(8.7±4.5 ~ 9.9±4.7,p = 0.09)，而主动-无辅助组工作距离无改善趋势(14.0±0 ~ 13.5±1.1,ns)。结论:非辅助机器人模式优于辅助机器人模式的优势尚未得到证实。然而，非辅助模式似乎并没有减少这一人群的运动恢复，尽管与有辅助的人群相比，他们在较短的工作距离上的动作较少。似乎努力的要求可能是神经康复中恢复的决定因素，但需要进一步精心设计的研究来充分理解这一现象。

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

Restorative neurology and neuroscience 医学-神经科学

CiteScore

5.40

自引率

3.60%

发文量

审稿时长

>12 weeks

期刊介绍： This interdisciplinary journal publishes papers relating to the plasticity and response of the nervous system to accidental or experimental injuries and their interventions, transplantation, neurodegenerative disorders and experimental strategies to improve regeneration or functional recovery and rehabilitation. Experimental and clinical research papers adopting fresh conceptual approaches are encouraged. The overriding criteria for publication are novelty, significant experimental or clinical relevance and interest to a multidisciplinary audience. Experiments on un-anesthetized animals should conform with the standards for the use of laboratory animals as established by the Institute of Laboratory Animal Resources, US National Academy of Sciences. Experiments in which paralytic agents are used must be justified. Patient identity should be concealed. All manuscripts are sent out for blind peer review to editorial board members or outside reviewers. Restorative Neurology and Neuroscience is a member of Neuroscience Peer Review Consortium.