편마비환자에서 로봇 보조 상지 재활치료의 효과
Effects of Robot-assisted Upper Limb Training on Hemiplegic Patients
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참고문헌
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초록
Objective: To investigate the effects of short-term robot-assisted upper limb training on hemiplegicpatients compared to conventional physical therapy. Method: This study was a prospective, single-blinded, randomized controlled trial. Eighteen hemiplegicpatients due to brain lesions were randomly assigned to: (1) robot-assisted upper limb training andconventional upper limb physical therapy for 30 min a day, respectively (Robot group); or (2) conventionalupper limb physical therapy for 30 min twice a day (Conventional group). All interventions were providedfor 2 weeks, 5 times a week. Each patient was evaluated at pre- and post-treatment by the Fugl-Meyerassessment-upper extremity (FMA-UE), Jebsen hand function test (JHFT), grip power, modified Barthelindex-upper extremity (MBI-UE), line bisection test, and Albert test. Results: The Robot group showed significant improvement in FMA-UE (pre: 13.22 ± 14.20, post: 21.67± 15.84; p = 0.018), MBI-UE (pre: 14.33 ± 7.42, post: 16.56 ± 6.95; p = 0.041), and line bisectiontest (pre: 25.15 ± 34.48, post: 14.93 ± 28.38; p = 0.043). The Conventional group showed significantimprovement only in MBI-UE (pre: 9.22 ± 6.06, post: 15.56 ± 6.19; p = 0.008). The improvementin MBI-UE was larger in the Conventional group than Robot group (6.33 ± 3.28 vs. 2.22 ± 2.49; p= 0.014). Conclusion: This study suggests that short-term robot-assisted upper limb training may improve upperlimb function in hemiplegic patients. However, proper physical therapy may be needed to transferimproved upper limb function to activity of daily living. In addition, goal-directed reaching tasks usinga robot are expected to be a treatment option for hemineglect.
Abstract
Objective: To investigate the effects of short-term robot-assisted upper limb training on hemiplegicpatients compared to conventional physical therapy. Method: This study was a prospective, single-blinded, randomized controlled trial. Eighteen hemiplegicpatients due to brain lesions were randomly assigned to: (1) robot-assisted upper limb training andconventional upper limb physical therapy for 30 min a day, respectively (Robot group); or (2) conventionalupper limb physical therapy for 30 min twice a day (Conventional group). All interventions were providedfor 2 weeks, 5 times a week. Each patient was evaluated at pre- and post-treatment by the Fugl-Meyerassessment-upper extremity (FMA-UE), Jebsen hand function test (JHFT), grip power, modified Barthelindex-upper extremity (MBI-UE), line bisection test, and Albert test. Results: The Robot group showed significant improvement in FMA-UE (pre: 13.22 ± 14.20, post: 21.67± 15.84; p = 0.018), MBI-UE (pre: 14.33 ± 7.42, post: 16.56 ± 6.95; p = 0.041), and line bisectiontest (pre: 25.15 ± 34.48, post: 14.93 ± 28.38; p = 0.043). The Conventional group showed significantimprovement only in MBI-UE (pre: 9.22 ± 6.06, post: 15.56 ± 6.19; p = 0.008). The improvementin MBI-UE was larger in the Conventional group than Robot group (6.33 ± 3.28 vs. 2.22 ± 2.49; p= 0.014). Conclusion: This study suggests that short-term robot-assisted upper limb training may improve upperlimb function in hemiplegic patients. However, proper physical therapy may be needed to transferimproved upper limb function to activity of daily living. In addition, goal-directed reaching tasks usinga robot are expected to be a treatment option for hemineglect.
참고문헌 (32)
- Kwakkel G, "Probability of regaining dexterity in the flaccid upper limb:impact of severity of paresis and time since onset in acute stroke", Stroke, 34, pp.2181~2186 (2003)
- Hendricks HT, "Motor recovery after stroke: a systematic review of the literature", Arch Phys Med Rehabil, 83, pp.1629~1637 (2002)
- Lai SM, "Persisting consequences of stroke measured by the Stroke Impact Scale", Stroke, 33, pp.1840~1844 (2002)
- Nichols-Larsen DS, "Factors influencing stroke survivors’ quality of life during subacute recovery", Stroke, 36, pp.1480~1484 (2005)
- Volpe BT, "Is robot-aided sensorimotor training in stroke rehabilitation a realistic option?", Curr Opin Neurol, 14, pp.745~752 (2001)
- Mehrholz J, "Electromechanical and robot-assisted arm training for improving arm function and activities of daily living after stroke", Stroke (2009)
- Mehrholz J, "Electromechanical and robot-assisted arm training for improving generic activities of daily living, arm function, and arm muscle strength after stroke", Cochrane Database Syst Rev, 6, pp.CD006876~ (2012)
- Volpe BT, "Robot training enhanced motor outcome in patients with stroke maintained over 3 years", Neurology, 53, pp.1874~1876 (1999)
- Volpe BT, "A novel approach to stroke rehabilitation: robot-aided sensorimotor stimulation", Neurology, 54, pp.1938~1944 (2000)
- Fasoli SE, "Robotic therapy for chronic motor impairments after stroke : Follow-up results", Arch Phys Med Rehabil, 85, pp.1106~1111 (2004)
- Fasoli SE, "Effects of robotic therapy on motor impairment and recovery in chronic stroke", Arch Phys Med Rehabil, 84, pp.477~482 (2003)
- Ferraro M, "Robot-aided sensorimotor arm training improves outcome in patients with chronic stroke", Neurology, 61, pp.1604~1607 (2003)
- Volpe BT, "Intensive sensorimotor arm training mediated by therapist or robot improves hemiparesis in patients with chronic stroke", Neurorehabil Neural Repair, 22, pp.305~310 (2008)
- Lo AC, "Robot-assisted therapy for long-term upper-limb impairment after stroke", N Engl J Med, 362, pp.1772~1783 (2010)
- Fugl-Meyer AR, "The post-stroke hemiplegic patient. 1. a method for evaluation of physical performance", Scand J Rehabil Med, 7, pp.13~31 (1975)
- Platz T, "Reliability and validity of arm function assessment with standardized guidelines for the Fugl-Meyer Test, Action Research Arm Test and Box and Block Test: a multicentre study", Clin Rehabil, 19, pp.404~411 (2005)
- Jebsen RH, "An objective and standardized test of hand function", Arch Phys Med Rehabil, 50, pp.311~319 (1969)
- 김정환, "Jebsen Hand Function Test의 신점수체계", Annals of Rehabilitation Medicine, 31(6), pp.623~629 (2007), 대한재활의학회
- Shah S, "Improving the sensitivity of the Barthel Index for stroke rehabilitation", J Clin Epidemiol, 42, pp.703~709 (1989)
- Schenkenberg T, "Line bisection and unilateral visual neglect in patients with neurologic impairment", Neurology, 30, pp.509~517 (1980)
- Albert ML, "A simple test of visual neglect", Neurology, 23, pp.658~664 (1973)
- Nudo RJ, "Use-dependent alterations of movement representations in primary motor cortex of adult squirrel monkeys", J Neurosci, 16, pp.785~807 (1996)
- Teasell R, "Plasticity and reorganization of the brain post stroke", Top Stroke Rehabil, 12, pp.11~26 (2005)
- Turkstra LS, "The neuroscience of recovery and rehabilitation: what have we learned from animal research?", Arch Phys Med Rehabil, 84, pp.604~612 (2003)
- Krebs HI, "Robotic therapy: the tipping point", Am J Phys Med Rehabil, 91, pp.S290~S297 (2012)
- Hubbard IJ, "Taskspecific training: evidence for and translation to clinical practice", Occup Ther Int, 16, pp.175~189 (2009)
- Krebs HI, "Robot-aided neurorehabilitation: a robot for wrist rehabilitation", IEEE Trans Neural Syst Rehabil Eng, 15, pp.327~335 (2007)
- Staubli P, "Effects of intensive arm training with the rehabilitation robot ARMin II in chronic stroke patients: four single-cases", J Neuroeng Rehabil, 6, pp.46~ (2009)
- Sale P, "Hand robotics rehabilitation: feasibility and preliminary results of a robotic treatment in patients with hemiparesis", Stroke Res Treat, 2012, pp.820931~ (2012)
- Hwang CH, "Individual finger synchronized robot-assisted hand rehabilitation in subacute to chronic stroke: a prospective randomized clinical trial of efficacy", CLINICAL REHABILITATION, 26(8), pp.696~704 (2012), SAGE PUBLICATIONS LTD
- Bowen A, "Reasons for variability in the reported rate of occurrence of unilateral spatial neglect after stroke", Stroke, 30, pp.1196~1202 (1999)
- Marshall RS, "Rehabilitation approaches to hemineglect", Neurologist, 15, pp.185~192 (2009)