| Summary: | 碩士 === 長庚大學 === 職能治療學系 === 101 === Objective
Robot-assisted therapy (RT) has been used in many stroke rehabilitation program. Majority of review literatures has proved that RT shows therapeutic benefits in motor functional recovery. Compared to traditional rehabilitation, RT has higher density, flexibility, intensity, and specificity. Besides, many robots contain a variety of treatment modes that can serve a broader population of stroke patients. But some studies found that the therapeutic benefits are less in patients with lower motor function.
We observed the robot-assisted therapy (BiManu Track) and found that stroke patients with different motor function levels had variable performances in active training mode, which may result from the different muscle contraction. The patients with lower motor function could not perform the active training independently due to the flexor synergy and muscle cocontraction. It consequently leaded to variable therapeutic benefits. So we tried to combine the robot-assisted therapy with neuromuscular electrical stimulation to improve the consistency and muscle contraction.
Methods
Total of 29 chronic stroke patients were randomized into combination (RES), placebo (RTm) and control (CR) group. Each subjects received 90 minutes therapy, every weekdays, for 4 weeks. Pre-treatment and post-treatment measures included Fugl-Meyer Upper Extremity Motor Function Test, Modified Ashworth Scale and kinematic analysis.
Results
After 4 weeks of treatment, the combined therapy group showed some therapeutic benefits in motor function and muscle tone, but the benefits of the three groups did not reach the significant level. However, it has significantly lower total displacement, higher peak velocity and higher the percentage of movement time where peak velocity occurs than placebo and control group. And the combined therapy group also avoided the unnecessary shoulder and trunk compensation.
Conclusion
The current results showed robot-assisted therapy combined with neuromuscular electrical stimulation produced better motor control and motor planning than RTm and CR groups when performing an unilateral/ bilateral reaching task. But generally, all three groups showed some therapeutic benefits in motor function, and no significances in clinical outcome measures. Further research is needed to investigate the best dosage of combined therapy and to obtain more evidences in activities of daily living.
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