The effects of upper limb rehabilitation robot-assisted training combined with mirror therapy on unilateral spatial neglect in stroke patients_West China Medical Journal

Authors：

WANG Liang , ZHU Dongyan , XU Qian , HAN Zhenzhen , ZHOU Sanlian ,  HUANG Zhidong

Department of Rehabilitation Medicine, the Second Affiliated Hospital of Nantong University, Nantong, Jiangsu 226001, P. R. China;

Corresponding?author：

HUANG Zhidong, Email: winterhzd@163.com

Keywords：

Upper limb rehabilitation robot-assisted training; Mirror therapy; Unilateral spatial neglect

DOI：

10.7507/1002-0179.201912247

Video：

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Objective To observe the effects of upper limb rehabilitation robot-assisted training combined with mirror therapy on unilateral spatial neglect (USN) in stroke patients.Methods A total of 40 patients with USN admitted to the Department of Rehabilitation Medicine of the Second Affiliated Hospital of Nantong University from January 2017 to December 2018 were selected and randomly divided into the trial group and the control group, with 20 cases in each group. The trial group used upper limb rehabilitation robot-assisted training combined with mirror therapy and USN comprehensive rehabilitation treatment. The control group patients only received USN comprehensive rehabilitation treatment. All patients continued treatment for 4 weeks. Before treatment and after 4 weeks of treatment, the modified Barthel index (MBI) was used to assess the activities of daily living, the Fugl-Meyer assessment (FMA) was used to assess motor function, and the Catherine-Bergego scale was used to assess the degree of USN.Results There was no statistically significant difference in general information between the two groups of patients (P>0.05). There was no significant difference in MBI, FMA or USN degree scores between the two groups before treatment (P>0.05). After 4 weeks of treatment, the MBI, FMA and USN degree scores of the two groups were improved compared with those before treatment (P<0.05). The improvements in MBI, FMA and USN degree scores of the trial group were 14.75±1.97, 17.05±3.93 and 5.25±2.29, respectively, and those of the control group were 9.75±4.44, 8.30±2.06 and 3.10±0.72, respectively, and the differences were statistically significant (P<0.05).Conclusions Upper limb rehabilitation robot-assisted training combined with mirror therapy can effectively improve the spatial neglect of USN patients, and improve the ability of daily living and motor functions.

Citation： WANG Liang, ZHU Dongyan, XU Qian, HAN Zhenzhen, ZHOU Sanlian, HUANG Zhidong. The effects of upper limb rehabilitation robot-assisted training combined with mirror therapy on unilateral spatial neglect in stroke patients. West China Medical Journal, 2021, 36(4): 471-475. doi: 10.7507/1002-0179.201912247 Copy

1.	洪文軍, 陶靜. 腦卒中后單側忽略的研究進展. 中國康復, 2016, 31(4): 305-308.
2.	張慶, 肖洪奇, 余佳丹, 等. 重復經顱磁刺激對腦卒中患者單側忽略康復療效的系統評價. 中國循證醫學雜志, 2018, 18(2): 163-171.
3.	Chechlacz M, Rotshtein P, Bickerton WL, et al. Separating neural correlates of allocentric and egocentric neglect: distinct cortical sites and common white matter disconnections. Cogn Neuropsychol, 2010, 27(3): 277-303.
4.	Rorden C, Hjaltason H, Fillmore P, et al. Allocentric neglect strongly associated with egocentric neglect. Neuropsychologia, 2012, 50(6): 1151-1157.
5.	Eskes GA, Butler B. Using limb movements to improve spatial neglect: the role of functional electrical stimulation. Restor Neurol Neurosci, 2006, 24(4/5/6): 385-398.
6.	杜曉霞, 宋魯平, 徐瑩, 等. 棱鏡適應技術治療卒中后偏側空間忽略的臨床研究. 中國醫學前沿雜志(電子版), 2013(10): 26-30.
7.	王永慧, 楊廣軍, 董磊. 經顱磁刺激對腦卒中后單側空間忽略患者運動功能康復的作用. 醫學臨床研究, 2014(5): 876-878.
8.	陳嶠鸚, 楊葉珠, 朱美紅, 等. 感覺整合訓練對腦卒中單側空間忽略患者生活質量的影響. 中華物理醫學與康復雜志, 2012, 34(3): 176-177.
9.	顧琦, 田湉, 張芳芳, 等. 上肢康復機器人輔助治療對改善腦卒中單側忽略的療效觀察. 中國康復醫學雜志, 2020, 35(2): 166-170.
10.	全國第四屆腦血管病學術會議. 各類腦血管疾病診斷要點. 中華神經科雜志, 1996, 29(6): 379-380.
11.	Dormal V, Schuller AM, Nihoul J, et al. Causal role of spatial attention in arithmetic problem solving: evidence from left unilateral neglect. Neuropsychologia, 2014, 60: 1-9.
12.	中華醫學會. 臨床診療指南物理醫學與康復分冊. 北京: 人民衛生出版社, 2005: 181.
13.	張華. 引導性上肢協調訓練對腦卒中所致單側空間忽略的療效觀察. 中國康復, 2016, 31(1): 42-44.
14.	Gladstone DJ, Danells CJ, Black SE. The fugl-meyer assessment of motor recovery after stroke: a critical review of its measurement properties. Neurorehabil Neural Repair, 2002, 16(3): 232-240.
15.	熊蓓, 周曉琴. 急性期腦卒中伴單側空間忽略患者的康復指導. 現代醫藥衛生, 2016(3): 431-432.
16.	許通文, 余木生, 王偉鋒. 針刺聯合改良強制性運動療法對腦卒中單側忽略和日常生活活動能力的效果. 廣東醫學, 2015, 36(17): 2745-2748.
17.	李艷麗, 徐基民, 陳之罡, 等. 單側空間忽略治療的中西醫研究進展. 中國中醫急癥, 2016, 25(2): 279-281, 288.
18.	梁文銳, 張啟富. 強化軀干旋轉訓練對腦卒中單側空間忽略的影響. 廣西醫科大學學報, 2012, 29(3): 410-411.
19.	王永慧. 運動再學習方法干預對腦卒中后單側空間忽略患者運動功能的影響. 山東醫藥, 2014, 54(5): 30-31.
20.	Saroul N, Akkari M, Pavier Y, et al. Baha-mediated rehabilitation of patients with unilateral deafness: selection criteria. Audiol Neurootol, 2014, 19(2): 85-90.
21.	Azouvi P, Jacquin-Courtois S, Luauté J. Rehabilitation of unilateral neglect: evidence-based medicine. Ann Phys Rehabil Med, 2017, 60(3): 191-197.
22.	李元進, 萬裕萍. 頭針與上肢機器人聯動療法對腦卒中偏癱上肢功能的影響. 長江大學學報(自科版), 2016, 13(30): 38-40, 47.
23.	唐朝正, 陳昌成, 丁政, 等. 基于鏡像神經元理論的動作觀察在腦卒中后肩手綜合征疼痛康復中的應用. 中國康復醫學雜志, 2016, 31(2): 145-149.
24.	李怡君, 林克忠, 鄭筱儒. 臺灣地區腦卒中作業治療的科研發展: 以鏡像治療為例. 中國康復, 2015, 30(6): 432-434.
25.	蔣金鵬, 劉洪武, 王志雙. 鏡像療法配合康復訓練對腦卒中偏癱患者上肢運動功能的臨床療效分析. 中國醫學裝備, 2015(9): 107-109.
26.	王萍, 單春雷, 王健. 單側空間忽略的康復研究進展. 中國康復理論與實踐, 2020, 26(1): 59-61.
27.	何思錦, 周劍英, 陳小霞, 等. 鏡像療法在腦卒中后康復治療中的研究進展. 華西醫學, 2020, 35(6): 729-733.
28.	梁天佳, 吳小平, 莫明玉. 上肢康復機器人在腦卒中單側空間忽略康復中的作用. 中國康復理論與實踐, 2012, 18(4): 369-371.
29.	Pandian JD, Arora R, Kaur P, et al. Mirror therapy in unilateral neglect after stroke (MUST trial): a randomized controlled trial. Neurology, 2014, 83(11): 1012-1017.
30.	朱朝疊, 董婭南, 鄭發宇, 等. 上肢機器人在腦卒中患者功能恢復中的應用. 中國繼續醫學教育, 2018, 10(25): 146-147.
31.	榮積峰, 丁力, 張雯, 等. 康復機器人結合鏡像療法對腦卒中偏癱患者上肢功能的效果. 中國康復理論與實踐, 2019, 25(6): 709-713.

1. 洪文軍, 陶靜. 腦卒中后單側忽略的研究進展. 中國康復, 2016, 31(4): 305-308.
2. 張慶, 肖洪奇, 余佳丹, 等. 重復經顱磁刺激對腦卒中患者單側忽略康復療效的系統評價. 中國循證醫學雜志, 2018, 18(2): 163-171.
3. Chechlacz M, Rotshtein P, Bickerton WL, et al. Separating neural correlates of allocentric and egocentric neglect: distinct cortical sites and common white matter disconnections. Cogn Neuropsychol, 2010, 27(3): 277-303.
4. Rorden C, Hjaltason H, Fillmore P, et al. Allocentric neglect strongly associated with egocentric neglect. Neuropsychologia, 2012, 50(6): 1151-1157.
5. Eskes GA, Butler B. Using limb movements to improve spatial neglect: the role of functional electrical stimulation. Restor Neurol Neurosci, 2006, 24(4/5/6): 385-398.
6. 杜曉霞, 宋魯平, 徐瑩, 等. 棱鏡適應技術治療卒中后偏側空間忽略的臨床研究. 中國醫學前沿雜志(電子版), 2013(10): 26-30.
7. 王永慧, 楊廣軍, 董磊. 經顱磁刺激對腦卒中后單側空間忽略患者運動功能康復的作用. 醫學臨床研究, 2014(5): 876-878.
8. 陳嶠鸚, 楊葉珠, 朱美紅, 等. 感覺整合訓練對腦卒中單側空間忽略患者生活質量的影響. 中華物理醫學與康復雜志, 2012, 34(3): 176-177.
9. 顧琦, 田湉, 張芳芳, 等. 上肢康復機器人輔助治療對改善腦卒中單側忽略的療效觀察. 中國康復醫學雜志, 2020, 35(2): 166-170.
10. 全國第四屆腦血管病學術會議. 各類腦血管疾病診斷要點. 中華神經科雜志, 1996, 29(6): 379-380.
11. Dormal V, Schuller AM, Nihoul J, et al. Causal role of spatial attention in arithmetic problem solving: evidence from left unilateral neglect. Neuropsychologia, 2014, 60: 1-9.
12. 中華醫學會. 臨床診療指南物理醫學與康復分冊. 北京: 人民衛生出版社, 2005: 181.
13. 張華. 引導性上肢協調訓練對腦卒中所致單側空間忽略的療效觀察. 中國康復, 2016, 31(1): 42-44.
14. Gladstone DJ, Danells CJ, Black SE. The fugl-meyer assessment of motor recovery after stroke: a critical review of its measurement properties. Neurorehabil Neural Repair, 2002, 16(3): 232-240.
15. 熊蓓, 周曉琴. 急性期腦卒中伴單側空間忽略患者的康復指導. 現代醫藥衛生, 2016(3): 431-432.
16. 許通文, 余木生, 王偉鋒. 針刺聯合改良強制性運動療法對腦卒中單側忽略和日常生活活動能力的效果. 廣東醫學, 2015, 36(17): 2745-2748.
17. 李艷麗, 徐基民, 陳之罡, 等. 單側空間忽略治療的中西醫研究進展. 中國中醫急癥, 2016, 25(2): 279-281, 288.
18. 梁文銳, 張啟富. 強化軀干旋轉訓練對腦卒中單側空間忽略的影響. 廣西醫科大學學報, 2012, 29(3): 410-411.
19. 王永慧. 運動再學習方法干預對腦卒中后單側空間忽略患者運動功能的影響. 山東醫藥, 2014, 54(5): 30-31.
20. Saroul N, Akkari M, Pavier Y, et al. Baha-mediated rehabilitation of patients with unilateral deafness: selection criteria. Audiol Neurootol, 2014, 19(2): 85-90.
21. Azouvi P, Jacquin-Courtois S, Luauté J. Rehabilitation of unilateral neglect: evidence-based medicine. Ann Phys Rehabil Med, 2017, 60(3): 191-197.
22. 李元進, 萬裕萍. 頭針與上肢機器人聯動療法對腦卒中偏癱上肢功能的影響. 長江大學學報(自科版), 2016, 13(30): 38-40, 47.
23. 唐朝正, 陳昌成, 丁政, 等. 基于鏡像神經元理論的動作觀察在腦卒中后肩手綜合征疼痛康復中的應用. 中國康復醫學雜志, 2016, 31(2): 145-149.
24. 李怡君, 林克忠, 鄭筱儒. 臺灣地區腦卒中作業治療的科研發展: 以鏡像治療為例. 中國康復, 2015, 30(6): 432-434.
25. 蔣金鵬, 劉洪武, 王志雙. 鏡像療法配合康復訓練對腦卒中偏癱患者上肢運動功能的臨床療效分析. 中國醫學裝備, 2015(9): 107-109.
26. 王萍, 單春雷, 王健. 單側空間忽略的康復研究進展. 中國康復理論與實踐, 2020, 26(1): 59-61.
27. 何思錦, 周劍英, 陳小霞, 等. 鏡像療法在腦卒中后康復治療中的研究進展. 華西醫學, 2020, 35(6): 729-733.
28. 梁天佳, 吳小平, 莫明玉. 上肢康復機器人在腦卒中單側空間忽略康復中的作用. 中國康復理論與實踐, 2012, 18(4): 369-371.
29. Pandian JD, Arora R, Kaur P, et al. Mirror therapy in unilateral neglect after stroke (MUST trial): a randomized controlled trial. Neurology, 2014, 83(11): 1012-1017.
30. 朱朝疊, 董婭南, 鄭發宇, 等. 上肢機器人在腦卒中患者功能恢復中的應用. 中國繼續醫學教育, 2018, 10(25): 146-147.
31. 榮積峰, 丁力, 張雯, 等. 康復機器人結合鏡像療法對腦卒中偏癱患者上肢功能的效果. 中國康復理論與實踐, 2019, 25(6): 709-713.

West China Medical Journal

The effects of upper limb rehabilitation robot-assisted training combined with mirror therapy on unilateral spatial neglect in stroke patients

Abstract Full text Figures/Tables Video References Cited by

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