學院

醫學院

系所

職能治療學系

題名

Sequencing bilateral robot-assisted arm therapy and constraint-induced therapy improves reach to press and trunk kinematics in patients with stroke

作者

Hsieh, Y-W., Liing, R-J., Lin, K-C., Wu, C-Y.^*, Liou, T-H., Lin, J-C., & Hung, J-W.

期刊名稱

Journal of NeuroEngineering and Rehabilitation（SCIE-Indexed）

發表日期

2016

著作性質

原著

語文

英文

關鍵字

Sequential combination therapy; Robotic rehabilitation; Constraint-induced; Upper extremity

摘要

Background: Combination of robotic-assisted therapy (RT) and a modified form of constraint-induced therapy (mCIT) shows promise for improving motor function of patients with stroke. However, it is unclear whether the changes of motor control strategies are concomitant with the improvements in motor function after combination of RT and mCIT (RT+mCIT). This study aimed to investigate the effects of the sequential combination of RT+mCIT compared with RT alone on the strategies of motor control measured by kinematic analysis and on motor function and daily performance measured by clinical scales.

Methods: Thirty-four patients with chronic stroke were enrolled in this study. The data were derived from part of a single-blinded randomized controlled trial. Participants in the RT+mCIT and RT groups both received 20 therapy sessions (90 to 105 minutes/day, 5 days for 4 weeks). Patients in the RT+mCIT group received 10 RT sessions for first 2 weeks and then 10 mCIT sessions for the next 2 weeks. The primary outcome was kinematic variables in a task of reaching to press a desk bell. The secondary outcomes included the Wolf Motor Function Test, Functional Independence Measure, and the Nottingham Extended Activities of Daily Living. All outcome measures were administered before and after intervention.

Results: RT+mCIT and RT demonstrated different benefits on motor control strategies. RT+mCIT uniquely improved motor control strategies by reducing shoulder abduction, increasing elbow extension, and decreasing trunk compensatory movement during the reaching task. Motor function and quality 49 of the affected limb was improved, and patients achieved greater independence in instrumental activities of daily living. The patients who received RT improved force generation at movement initiation.

Conclusion: The results indicate that a combination of RT and mCIT could be an effective approach to improve stroke rehabilitation outcomes, achieving better motor control strategies, motor function, and functional independence of instrumental activities of daily living.