将手外骨骼整合到面向目标的临床和家庭中风和脊髓损伤康复中。

IF 4.6 Q2 MATERIALS SCIENCE, BIOMATERIALS

ACS Applied Bio Materials Pub Date : 2022-10-02 eCollection Date: 2022-01-01 DOI:10.1177/20556683221130970

Aaron Yurkewich, Sara Ortega, José Sanchez, Rosalie H Wang, Etienne Burdet

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引用次数: 5

摘要

机器人外骨骼正在成为康复和辅助技术，同时恢复功能并使残疾人能够独立。目的:我们研究了外骨骼支持的目标导向康复计划对中风或脊髓损伤(SCI)后手部损伤患者的可行性和矫形和恢复效果。方法:在临床和家庭组件的目标导向治疗方案中，使用可穿戴的无系绳手外骨骼进行单臂病例系列可行性研究。治疗师训练中风和脊髓损伤患者在康复训练、日常生活活动和患者选择的目标中使用手外骨骼。每位患者连续5天接受1小时的临床培训，然后连续2天将外骨骼带回家执行治疗师推荐的任务。目标实现量表(GAS)和盒块测试(BBT)分别在基线、临床治疗后和家庭使用后、佩戴和不佩戴外骨骼时进行。采用系统可用性量表(SUS)、运动活动日志和Fugl-Meyer评估来评估干预的可接受性、依从性、可用性和有效性。结果:4例脑卒中患者(Chedoke McMaster手部2-4期)和1例脊髓损伤患者(ASIA C8 Motor Stage 1)在损伤后23±19个月佩戴手外骨骼在诊所进行280±23次重复运动，并在家中进行额外的目标导向任务。与基线相比，在7天的治疗计划后，患者在外骨骼辅助(ΔGAS: 18±10，ΔBBT: 1±5)和非辅助(ΔGAS: 14±14，ΔBBT: 3±4)评估中表现更好地完成了自己的目标和灵活性任务。治疗师和患者的SUS评分为“良好”(78±6)，无不良事件报道。结论:外骨骼支持的脑卒中和脊髓损伤治疗方案结合临床和家庭训练是可行的。

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Integrating hand exoskeletons into goal-oriented clinic and home stroke and spinal cord injury rehabilitation.

Introduction: Robotic exoskeletons are emerging as rehabilitation and assistive technologies that simultaneously restore function and enable independence for people with disabilities.

Aim: We investigated the feasibility and orthotic and restorative effects of an exoskeleton-supported goal-directed rehabilitation program for people with hand impairments after stroke or Spinal Cord Injury (SCI).

Method: A single-arm case-series feasibility study was conducted using a wearable untethered hand exoskeleton during goal-directed therapy programs with in-clinic and at-home components. Therapists trained stroke and SCI patients to use a hand exoskeleton during rehabilitation exercises, activities of daily living and patient-selected goals. Each patient received a 1-hour in-clinic training session on five consecutive days, then took the exoskeleton home for two consecutive days to perform therapist-recommended tasks. Goal Attainment Scaling (GAS) and the Box and Block Test (BBT) were administered at baseline, after in-clinic therapy and after home use, with and again without wearing the exoskeleton. The System Usability Scale (SUS), Motor Activity Log, and Fugl-Meyer Assessment were also administered to assess the intervention's acceptability, adherence, usability and effectiveness.

Results: Four stroke patients (Chedoke McMaster Stage of Hand 2-4) and one SCI patient (ASIA C8 Motor Stage 1) 23 ± 19 months post-injury wore the hand exoskeleton to perform 280 ± 23 exercise repetitions in the clinic and additional goal-oriented tasks at home. The patients performed their own goals and the dexterity task with higher performance following the 7-days therapy program in comparison to baseline for both exoskeleton-assisted (ΔGAS: 18 ± 10, ΔBBT: 1 ± 5) and unassisted (ΔGAS: 14 ± 14, ΔBBT: 3 ± 4) assessments. Therapists and patients provided 'good' SUS ratings of 78 ± 6 and no harmful events were reported.

Conclusions: The exoskeleton-supported stroke and SCI therapy program with in-clinic and at-home training components was feasible.

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来源期刊

ACS Applied Bio Materials Chemistry-Chemistry (all)

CiteScore

9.40

自引率

2.10%

发文量

464

期刊介绍： ACS Applied Bio Materials is an interdisciplinary journal publishing original research covering all aspects of biomaterials and biointerfaces including and beyond the traditional biosensing, biomedical and therapeutic applications. The journal is devoted to reports of new and original experimental and theoretical research of an applied nature that integrates knowledge in the areas of materials, engineering, physics, bioscience, and chemistry into important bio applications. The journal is specifically interested in work that addresses the relationship between structure and function and assesses the stability and degradation of materials under relevant environmental and biological conditions.