The Effects of Combination of Robot‐Assisted Therapy With Task‐Specific or Impairment‐Oriented Training on Motor Function and Quality of Life in Chronic Stroke

Wiley - Tập 8 Số 8 - Trang 721-729 - 2016
Chung‐shan Chung‐shan, Yu‐wei Yu‐wei, Ching‐yi Ching‐yi, Yi‐ting Yi‐ting, Keh‐chung Keh‐chung, Chia‐ling Chia‐ling

Tóm tắt

AbstractBackgroundRobot‐assisted therapy (RT) is a promising intervention for stroke rehabilitation. RT hybridized with therapist‐mediated therapy (eg, RT plus task‐specific or impairment‐oriented training) may possibly yield functionally relevant improvements. A comparative study of the different combination regimens is needed.ObjectiveTo investigate the efficacy of RT combined with task‐specific training or impairment‐oriented training on motor function and quality of life in patients with chronic stroke.DesignA single‐blind, randomized comparative efficacy study.SettingTwo medical centers in Taiwan.ParticipantsTwenty‐one subjects with chronic stroke.InterventionsParticipants were recruited and randomized into 1 of 2 groups: (1) RT combined with task‐specific (RTT) training (enrolled, n = 11; completed, n = 11) or (2) RT combined with impairment‐oriented (RTI) training (enrolled, n = 10; completed, n = 9). Participants received 20 intervention sessions (90‐100 min/d, 5 d/wk for 4 weeks).OutcomesThe Fugl‐Meyer Motor Assessment Upper Extremity subscale, Stroke Impact Scale, Action Research Arm Test, and Medical Research Council Scale were administered at baseline, posttreatment, and at 3‐month follow‐up. Two‐way repeated‐measures analysis of variance was used to investigate the treatment effects.ResultsThe improvements of the RTT group in motor function measured by the Fugl‐Meyer Motor Assessment Upper Extremity subscale and quality of life assessed by the Stroke Impact Scale were significantly superior to the RTI group after the interventions. The improvements of the RTT group were maintained for 3 months. Both groups demonstrated significant within‐group improvements in motor function, muscle power, and quality of life.ConclusionsRTT may be a more compelling approach to enhance motor function and quality of life for a long‐term period than RTI. The combination of RT with task‐specific training and with impairment‐oriented training had similar benefits on upper limb motor function and muscle strength immediately after the interventions.

Tài liệu tham khảo

Mackay J., 2004, The Atlas of Heart Disease and Stroke 10.1016/j.rehab.2008.10.003 Platz T., 2004, Impairment‐oriented training (IOT)—scientific concept and evidence‐based treatment strategies, Restor Neurol Neurosci, 22, 301 Basteris A., 2014, Training modalities in robot‐mediated upper limb rehabilitation in stroke: A framework for classification based on a systematic review, J Neuroeng Rehabil, 11, 111, 10.1186/1743-0003-11-111 Mehrholz J., 2012, Electromechanical and robot‐assisted arm training for improving generic activities of daily living, arm function, and arm muscle strength after stroke, Cochrane Database Syst Rev, 6, CD006876 10.1310/tsr2002-171 Pignolo L., 2009, Robotics in neuro‐rehabilitation, J Rehabil Med, 41, 955, 10.2340/16501977-0434 10.1002/oti.275 10.1310/tsr1903-193 10.1177/1545968313481279 10.2522/ptj.20090160 10.1186/1743-0003-11-45 Linder S.M., 2015, Improving quality of life and depression after stroke through telerehabilitation, Am J Occup Ther, 69, 10.5014/ajot.2015.014498 10.1016/j.apmr.2006.11.021 10.1001/jama.296.17.2095 10.1177/1545968309335974 10.1191/0269215505cr904oa Reinkensmeyer D.J., 2012, Technologies and combination therapies for enhancing movement training for people with a disability, J Neuroeng Rehabil, 9, 17, 10.1186/1743-0003-9-17 Hsieh Y.W., 2014, Sequential combination of robot‐assisted therapy and constraint‐induced therapy in stroke rehabilitation: a randomized controlled trial, J Neurol, 261, 1037, 10.1007/s00415-014-7345-4 Norouzi‐Gheidari N., 2012, Effects of robot‐assisted therapy on stroke rehabilitation in upper limbs: Systematic review and meta‐analysis of the literature, J Rehabil Res Dev, 49, 479, 10.1682/JRRD.2010.10.0210 Lee Y.Y., 2015, Effects of combining robot‐assisted therapy with neuromuscular electrical stimulation on motor impairment, motor and daily function, and quality of life in patients with chronic stroke: A double‐blinded randomized controlled trial, J Neuroeng Rehabil, 12, 96, 10.1186/s12984-015-0088-3 10.1016/j.apmr.2004.01.028 10.1186/1743-0003-10-1 10.1016/S0028-3932(01)00005-7 10.1109/TNSRE.2007.903899 10.1053/apmr.2001.23982 10.1177/154596802401105171 Vellone E., 2014, Psychometric Evaluation of the Stroke Impact Scale 3.0, J Cardiovasc Nurs, 30, 229, 10.1097/JCN.0000000000000145 10.2340/16501977-0235 Nordin A., 2014, Intra‐rater and inter‐rater reliability at the item level of the Action Research Arm Test for patients with stroke, J Rehabil Med, 46, 738, 10.2340/16501977-1831 10.1016/j.apmr.2011.11.033 10.4324/9780203771587 10.1161/01.STR.0000087172.16305.CD Huang P.C., 2014, Predictors of motor, daily function, and quality‐of‐life improvements after upper‐extremity robot‐assisted rehabilitation in stroke, Am J Occup Ther, 68, 325, 10.5014/ajot.2014.010546 Arya K.N., 2011, Estimating the minimal clinically important difference of an upper extremity recovery measure in subacute stroke patients, Top Stroke Rehabil, 18, 599, 10.1310/tsr18s01-599 10.2174/1874440000802010094 10.1093/brain/awm311 10.3389/fneur.2013.00184 10.1177/1545968310368963 10.1097/WCO.0b013e32835c5ba0