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Rehabilitation Practice and Science

Translated Title

量化評估機器人上肢復健之運動控制

Abstract

Function of the upper limbs is crucial in daily activities. Motor recovery of upper limbs after stroke is slower and less complete than of lower limbs. During the recovery period, abnormal synergies always disturb daily life activity. Various therapeutic techniques have been developed to improve the function of upper limbs after stroke, such as the neuro-rehabilitation robot, which was developed in recent years and shows numerous positive outcomes for upper-limb facilitation after stroke. For the evaluation of motor recovery after stroke, Brunnstrom stages and the Modified Ashworth scale are commonly used and convenient. However, both depend heavily on the evaluator and are not very sensitive to motor recovery. The Fugl-Meyer assessment is another scale that focuses particularly on the motor function of the hand, such as grasp function and finger extension. Although the Fugl-Meyer assessment is a quantitative method of motor assessment and has good correlation with function, it depends on a trained physical therapist and is time-consuming. We used a quantitative method to evaluate the effect of neuro-robot treatment; the method was devised by adding a measuring system to the neuro-robot, which simultaneously provided treatment and an evaluation. We include 6 chronic stroke cases who received an additional neuro-rehabilitation robot treatment for 32 sessions lasting 50 minutes each, with 2 sessions per week, for 4 months. The assessment methods are Brunnstrom stages, the Modified Ashworth Scale, and a quantitative evaluation including the Fugl-Meyer assessment and Integration of Absolute Deviation of Torque. Integration of Absolute Deviation of Torque was proposed by Kung and was applied clinically for the first time. These were performed before the therapy, at the end of therapy, and 4 months after the end of therapy. Brunnstrom stages and the Modified Ashworth scale results show only a slight improvement, but a significant statistical difference was shown by the quantitative scales between pre-therapy and the end of therapy, pre-therapy and 4 months after the end of therapy, and the end and 4 months after the end of therapy. This study is the first to use such a quantitative evaluation method by a neuro-robot which also can be used for simultaneously therapeutic purposes during rehabilitation. The quantitative index may be a more sensitive and accurate evaluation method of the motor control of upper limbs after stroke, and may be used clinically. (Tw J Phys Med Rehabil 2012; 40(1): 19 - 24)

Language

Traditional Chinese

First Page

19

Last Page

24

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