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作者
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Hsieh, Y-W., Wu, C-Y., Lin, K-C.*,
Yao, G.,Wu, K-Y., Chang,
Y-J.
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摘要
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Background and Purpose: The increasing availability of robot-assisted therapy
(RT), which provides quantifiable, reproducible, interactive, and intensive
practice, holds promise for stroke rehabilitation, but data on its
dose-response relation are scanty. This study used 2 different intensities of
RT to examine the treatment effects of RT and the effect on outcomes of the
severity of initial motor deficits.
Methods: Fifty-four stroke patients were randomized to a 4-week intervention
of higher-intensity RT, lower-intensity RT, or control treatment (CT). The
primary outcome, the Fugl-Meyer Assessment (FMA),
was administered at baseline, midterm, and posttreatment. Secondary outcomes
included the Medical Research Council
(MRC) scale, the Motor Activity Log (MAL), and the physical domains of the Stroke Impact Scale (SIS).
Results: The higher-intensity RT group showed significantly greater
improvements on the FMA than the lower-intensity RT and CT groups at midterm
(P = 0.003 and P = 0.02) and at posttreatment (P = 0.04 and P = 0.02).
Within-group gains on the secondary outcomes were significant, but the
differences among the 3 groups did not reach significance. Recovery rates of
the higher-intensity RT group were higher than those of the lower-intensity
RT group, particularly on the FMA. Scatter plots with curve fitting showed
that patients with moderate motor deficits
gained more improvements than those with severe or mild deficits after the higher-intensity RT.
Conclusions: This study demonstrated the higher treatment intensity
provided by RT was associated with better motor outcome for patients with
stroke, which may shape further stroke rehabilitation.
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