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首页> 外文会议>2017 International Symposium on Wearable Robotics and Rehabilitation >Supplemental therapeutic conventional vs. robotic upper limb exercise in acute stroke rehabilitation a randomized: Assessor blinded study
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Supplemental therapeutic conventional vs. robotic upper limb exercise in acute stroke rehabilitation a randomized: Assessor blinded study

机译：急性卒中康复中辅助性上肢常规锻炼与机器人上肢辅助锻炼的随机对照：评估者盲研究

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Objectives: To compare and determine improvements on upper limb functional abilities recovery through intense ULE early after stroke using two interventions, the robotic device Armeo-Spring® (ARMEO) vs. therapist supervised Table Top (TT) exercises. Methods: Setting - Tertiary rehabilitation hospital, acute stroke inpatient rehabilitation program (IRF). Design - Blinded, randomized, pilot study. Participants - Acute stroke patients with unilateral hemiparesis ≥ 18 years of age with a minimum Fugl-Meyer Assessment (FMA) score of 8/66 or Modified Ashworth Scale (MAS) score of <;3. Intervention - Participants were randomized to TT or AREMO ULE groups in addition to usual required 3 hours of inpatient therapy. Main Outcome Measures - Number of completed treatment sessions; withdrawals; serious/adverse events; FuglMeyer Assessment (FMA), Functional Independence Measure (FIM); FIM efficiency; Modified Borg Rating of Perceived Exertion Scale (RPE) for the therapist. Results: Thirty-five participants enrolled in the study thus far (ARMEO=18 TT=17). Four participants withdrew from the study: one due to fatigue; one “did not want to participate any longer” (n=2) and medical complications. ARMEO participants on average had more training days (6.6) than TT (5.8), but did not report statistical significance (p =.65). FIM efficiency was not significant, however, was higher for the TT group (1.6 ± .70) than the ARMEO group (1.4 ± .54), a mean difference of -.16 (95% CI, -.65 to 0.32), p = .49. There was not a statistically significant median decrease in Borg when trained in either the ARMEO 0r TT group, p = .25, p = .56, respectively. Five ARMEO participants reported adverse events (AEs) (n=3, stomach issues; n=3, pain; n=2, fatigue; n=1, ARMEO malfunction. Eight TT participants reported AEs (n=2, stomach issues; n=2, fatigue; n=2, pain; n=1, fall; n=2, hypertension; n=2, scheduling issue). No serious adverse events (SAEs) were reported. Conclusions: This ongoing, blinded, randomized study depicts an acute post-stroke population that received standard IRF and an additional upper extremity exercise program. Based on these preliminary data, it is feasible to provide a supplemental functional exercise program in an IRF without SAEs or loss of compliance with regulations. Further data collection will determine the longterm functional impact of acute, post-stroke additional high intensity exercise and the use of robotic devices beyond to gain efficiency in rehabilitation care.
机译：目的：为了比较和确定在中风后早期通过剧烈的ULE进行的上肢功能能力恢复的改善，使用两种干预手段，即机器人设备Armeo-Spring®（ARMEO）与治疗师指导的桌面（TT）锻炼。方法：设置-第三级康复医院，急性中风住院康复计划（IRF）。设计-盲目，随机，初步研究。参与者-单侧偏瘫≥18岁的急性中风患者，其Fugl-Meyer评估（FMA）最低分数为8/66或改良Ashworth量表（MAS）分数<; 3。干预-除了通常需要住院3小时的治疗外，参与者还随机分为TT或AREMO ULE组。主要结果指标-完成治疗的次数；提款;严重/不良事件； FuglMeyer评估（FMA），功能独立性度量（FIM）； FIM效率；治疗师的感知运动量表（RPE）的修正Borg评分。结果：到目前为止，已有35名参与者参加了研究（ARMEO = 18 TT = 17）。四名参与者退出了研究：一位是由于疲劳；另一位是由于疲劳。一个“不想再参加”（n = 2）和医疗并发症。平均而言，ARMEO参与者的培训天数（6.6）比TT（5.8）多，但没有报告统计学意义（p = .65）。 FIM效率不显着，但是TT组（1.6±.70）高于ARMEO组（1.4±.54），平均差异为-.16（95％CI，-.65至0.32） ），p = 0.49。在两个ARMEO 0r TT组中训练时，Borg的中位数下降均无统计学意义，分别为p = .25，p = .56。五名ARMEO参与者报告了不良事件（AEs）（n = 3，胃部疾病； n = 3，疼痛； n = 2，疲劳； n = 1，ARMEO故障； n = 2，胃部疾病； n = 2，胃部疾病； n = 2，疲劳； n = 2，疼痛； n = 1，跌倒； n = 2，高血压； n = 2，日程安排问题）。未报告严重不良事件（SAE）。结论：这项正在进行的，盲目的随机研究描绘了接受标准IRF和额外的上肢运动计划的急性中风后人群，根据这些初步数据，可以在IRF中提供补充性功能运动计划而不会出现SAE或不遵守法规的情况。将确定急性中风后额外的高强度运动对长期功能的影响，并确定使用机器人设备以外的设备来提高康复护理的效率。

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