Chronic stroke survivors achieve comparable outcomes following virtual task specific repetitive training guided by a wearable robotic orthosis (UL-EX07) and actual task specific repetitive training guided by a physical therapist

被引:53
作者
Byl, Nancy N. [1 ]
Abrams, Gary M. [2 ]
Pitsch, Erica [1 ]
Fedulow, Irina [1 ]
Kim, Hyunchul [3 ]
Simkins, Matt [3 ]
Nagarajan, Srikantan [4 ]
Rosen, Jacob [3 ]
机构
[1] Univ Calif San Francisco, Sch Med, Dept Phys Therapy & Rehabil Med, San Francisco, CA 94158 USA
[2] Univ Calif San Francisco, Sch Med, Dept Neurol, VA Med Ctr, San Francisco, CA 94158 USA
[3] Univ Calif Santa Cruz, Sch Engn, Dept Comp Engn, Santa Cruz, CA 95064 USA
[4] Univ Calif San Francisco, Sch Med, Dept Radiol, VA Med Ctr, San Francisco, CA 94158 USA
关键词
Stroke; Physical therapy; Robotic training; Exoskeleton; Upper limb hemi-paresis; INDUCED MOVEMENT THERAPY; UPPER-LIMB IMPAIRMENT; UPPER-EXTREMITY; ASSISTED THERAPY; MOTOR RECOVERY; FUNCTIONAL OUTCOMES; NEURAL PLASTICITY; HEART-DISEASE; BLOCK TEST; REHABILITATION;
D O I
10.1016/j.jht.2013.06.001
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Survivors post stroke commonly have upper limb impairments. Patients can drive neural reorganization, brain recovery and return of function with task specific repetitive training (TSRT). Fifteen community independent stroke survivors (25-75 years, >6 months post stroke, Upper Limb Fugl Meyer [ULFM] scores 16-39) participated in this randomized feasibility study to compare outcomes of upper limb TSRT guided by a robotic orthosis (bilateral or unilateral) or a physical therapist. After 6 weeks of training (18 h), across all subjects, there were significant improvements in depression, flexibility, strength, tone, pain and voluntary movement (ULFM) (p < 0.05; effect sizes 0.49-3.53). Each training group significantly improved ULFM scores and range of motion without significant group differences. Virtual or actual TSRT performed with a robotic orthosis or a physical therapist significantly reduced arm impairments around the shoulder and elbow without significant gains in fine motor hand control, activities of daily living or independence. (C) 2013 Hanley & Belfus, an imprint of Elsevier Inc. All rights reserved.
引用
收藏
页码:343 / 352
页数:10
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