The effect of end-traction upper limb rehabilitation training system on upper limb motor dysfunction after stroke_West China Medical Journal

Authors：

JIANG Jian , LI Moyi , ZHU Cong , SHEN Peng , YOU Huangjun , YANG Chuyan ,  FENG Zhen

Department of Rehabilitation Medicine, the First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P. R. China;

Corresponding?author：

FENG Zhen, Email: fengzhenly@sina.com

Keywords：

Stroke; Upper limb motor dysfunction; End-traction upper limb rehabilitation training system

DOI：

10.7507/1002-0179.202003464

Video：

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Objective To explore the clinical effect of the end-traction upper limb rehabilitation training system on patients with upper limb motor dysfunction after stroke.Methods Patients with upper limb motor dysfunction who were admitted to the Department of Rehabilitation Medicine, the First Affiliated Hospital of Nanchang University from September to November 2019 were selected. According to the software, the patients were randomly divided into the experimental group and the control group. Both groups received conventional medical treatment, basic rehabilitation, and activities of daily living training. In addition, the control group received traditional occupational therapy, while the experimental group received end-traction upper limb rehabilitation training. The training time of both groups was 30 min/ (times ·d) and 5 days per week. Rehabilitation evaluation and recording were performed before and after the four-week treatment in both groups using the simplified upper extremity Fugl-Meyer assessment (FMA) and the modified Barthel index (MBI).Results A total of 36 patients were enrolled, with 18 in each group. All patients completed the experiment, and no special discomfort was observed. Before the treatment, there was no statistically significant difference in FMA and MBI between the experimental group [(13.22±3.13) and (49.66±6.81) points] and the control group [(14.78±1.70) and (51.67±6.65) points] (t=1.858, 0.896; P=0.072, 0.377). After four-week treatment, FMA and MBI in both groups improved significantly (P<0.05); the difference between the experimental group [(27.56±15.68) and (73.55±8.72) points] and the control group [(17.67±6.73) and (65.33±9.20) points] was statistically significant (t=2.459, 2.751; P=0.019, 0.009).Conclusions The end-traction upper limb rehabilitation training system can significantly improve the upper limb motor function of patients with upper limb motor dysfunction after stroke and improve the patients’ daily life ability. It is worthy of clinical promotion and application.

Citation： JIANG Jian, LI Moyi, ZHU Cong, SHEN Peng, YOU Huangjun, YANG Chuyan, FENG Zhen. The effect of end-traction upper limb rehabilitation training system on upper limb motor dysfunction after stroke. West China Medical Journal, 2020, 35(5): 563-567. doi: 10.7507/1002-0179.202003464 Copy

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13.	Fugl-Meyer AR, J??sk? L, Leyman I, et al. The post-stroke hemiplegic patient. 1. a method for evaluation of physical performance. Scand J Rehabil Med, 1975, 7(1): 13-31.
14.	閔瑜, 燕鐵斌. 改良Barthel指數表及其評分標準. 廣東省康復醫學會會刊, 2006(2): 6-9.
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16.	Fasoli SE, Krebs HI, Stein J, et al. Effects of robotic therapy on motor impairment and recovery in chronic stroke. Arch Phys Med Rehabil, 2003, 84(4): 477-482.
17.	Nef T, Quinter G, Müller R, et al. Effects of arm training with the robotic device ARMin I in chronic stroke: three single cases. Neurodegener Dis, 2009, 6(5-6): 240-251.
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19.	Alia C, Spalletti C, Lai S, et al. Neuroplastic changes following brain ischemia and their contribution to stroke recovery: novel approaches in neurorehabilitation. Front Cell Neurosci, 2017, 11: 76.
20.	宋迪, 吳軍發. 基因對腦卒中后神經可塑性的影響以及在精準康復中的作用. 中華物理醫學與康復雜志, 2018, 40(9): 712-715.
21.	楊頤, 王雪飛, 王麟鵬. 神經可塑性與腦卒中后運動功能恢復. 中國醫刊, 2016, 51(6): 15-19.
22.	李慶玲. 基于sEMG信號的外骨骼式機器人上肢康復系統研究. 哈爾濱工業大學, 2009.
23.	Balasubramanian S, Klein J, Burdet E. Robot-assisted rehabilitation of hand function. Curr Opin Neurol, 2010, 23(6): 661-670.
24.	曹明輝, 燕軍, 燕鐵斌, 等. MOTOmed不同模式運動訓練對青年志愿者體感誘發電位的影響. 中華物理醫學與康復雜志, 2010, 32(4): 270-272.
25.	Calabrò RS, Accorinti M, Porcari B, et al. Does hand robotic rehabilitation improve motor function by rebalancing interhemispheric connectivity after chronic stroke? Encouraging data from a randomised-clinical-trial. Clin Neurophysiol, 2019, 130(5): 767-780.
26.	Rowe JB, Chan V, Ingemanson ML, et al. Robotic assistance for training finger movement using a hebbian model: a randomized controlled trial. Neurorehabil Neural Repair, 2017, 31(8): 769-780.
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28.	張海燕, 吳方超, 李建華, 等. 上肢康復機器人輔助訓練對腦卒中患者上肢功能的影響. 中國運動醫學雜志, 2019, 38(10): 859-863.
29.	段麗麗. 上肢康復機器人對腦卒中偏癱患者上肢運動功能的影響. 臨床合理用藥雜志, 2020, 13(7): 123-124.
30.	黎祖連, 孫揚, 韓立坤, 等. 上肢機器人對腦卒中康復訓練效果的1例分析. 中國繼續醫學教育, 2019, 11(34): 158-160.
31.	朱琳, 劉霖, 宋為群. 重復性訓練對卒中患者偏癱上肢痙攣改善的療效觀察. 中國腦血管病雜志, 2007, 4(1): 18-21.
32.	Vanoglio F, Bernocchi P, Mulè C, et al. Feasibility and efficacy of a robotic device for hand rehabilitation in hemiplegic stroke patients:a randomized pilot controlled study. Clin Rehabil, 2017, 31(3): 351-360.

1. GBD 2016 Causes of Death Collaborators. Global, regional, and national age-sex specific mortality for 264 causes of death, 1980-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet, 2017, 390(10100): 1151-1210.
2. Institute for Health Metrics and Evaluation. Global Health Data Exchange. GBD Results Tool. [2020-03-01]. http://ghdx.healthdata.org/gbd-results-tool.
3. Kim AS, Cahill E, Cheng NT. Global stroke belt: geographic variation in stroke burden worldwide. Stroke, 2015, 46(12): 3564-3570.
4. Moran A, Gu D, Zhao D, et al. Future cardiovascular disease in China: markov model and risk factor scenario projections from the coronary heart disease policy model-China. Circ Cardiovasc Qual Outcomes, 2010, 3(3): 243-252.
5. 國家衛生和計劃生育委員會. 中國衛生和計劃生育統計年鑒2017. 北京: 中國協和醫科大學出版社, 2018.
6. Tyson SF, Hanley M, Chillala J, et al. Balance disability after stroke. Phys Ther, 2006, 86(1): 30-38.
7. Zhang C, Li-Tsang CW, Au RK. Robotic approaches for the rehabilitation of upper limb recovery after stroke: a systematic review and meta-analysis. Int J Rehabil Res, 2017, 40(1): 19-28.
8. Bertani R, Melegari C, De Cola MC, et al. Effects of robot-assisted upper limb rehabilitation in stroke patients: a systematic review with meta-analysis. Neurol Sci, 2017, 38(9): 1561-1569.
9. 中華神經科學會. 各類腦血管疾病診斷要點. 中華神經科雜志, 1996, 29(6): 379-380.
10. 王玉龍. 康復功能評定學. 北京: 人民衛生出版社, 2008: 164-168.
11. 中華醫學會神經病學分會, 中華醫學會神經病學分會腦血管病學組. 中國急性缺血性腦卒中診治指南2018. 中華神經科雜志, 2018, 51(9): 666-682.
12. 李響, 張洪蕊, 楊憲章, 等. 以任務目標為導向的上肢功能訓練對卒中患者日常生活活動能力的影響. 中國康復醫學雜志, 2017, 32(10): 1180-1182.
13. Fugl-Meyer AR, J??sk? L, Leyman I, et al. The post-stroke hemiplegic patient. 1. a method for evaluation of physical performance. Scand J Rehabil Med, 1975, 7(1): 13-31.
14. 閔瑜, 燕鐵斌. 改良Barthel指數表及其評分標準. 廣東省康復醫學會會刊, 2006(2): 6-9.
15. Duret C, Courtial O, Grosmaire AG. Kinematic measures for upper limb motor assessment during robot-mediated training in patients with severe sub-acute stroke. Restor Neurol Neurosci, 2016, 34(2): 237-245.
16. Fasoli SE, Krebs HI, Stein J, et al. Effects of robotic therapy on motor impairment and recovery in chronic stroke. Arch Phys Med Rehabil, 2003, 84(4): 477-482.
17. Nef T, Quinter G, Müller R, et al. Effects of arm training with the robotic device ARMin I in chronic stroke: three single cases. Neurodegener Dis, 2009, 6(5-6): 240-251.
18. Hidler J, Nichols D, Pelliccio M, et al. Advances in the understanding and treatment of stroke impairment using robotic devices. Top Stroke Rehabil, 2005, 12(2): 22-35.
19. Alia C, Spalletti C, Lai S, et al. Neuroplastic changes following brain ischemia and their contribution to stroke recovery: novel approaches in neurorehabilitation. Front Cell Neurosci, 2017, 11: 76.
20. 宋迪, 吳軍發. 基因對腦卒中后神經可塑性的影響以及在精準康復中的作用. 中華物理醫學與康復雜志, 2018, 40(9): 712-715.
21. 楊頤, 王雪飛, 王麟鵬. 神經可塑性與腦卒中后運動功能恢復. 中國醫刊, 2016, 51(6): 15-19.
22. 李慶玲. 基于sEMG信號的外骨骼式機器人上肢康復系統研究. 哈爾濱工業大學, 2009.
23. Balasubramanian S, Klein J, Burdet E. Robot-assisted rehabilitation of hand function. Curr Opin Neurol, 2010, 23(6): 661-670.
24. 曹明輝, 燕軍, 燕鐵斌, 等. MOTOmed不同模式運動訓練對青年志愿者體感誘發電位的影響. 中華物理醫學與康復雜志, 2010, 32(4): 270-272.
25. Calabrò RS, Accorinti M, Porcari B, et al. Does hand robotic rehabilitation improve motor function by rebalancing interhemispheric connectivity after chronic stroke? Encouraging data from a randomised-clinical-trial. Clin Neurophysiol, 2019, 130(5): 767-780.
26. Rowe JB, Chan V, Ingemanson ML, et al. Robotic assistance for training finger movement using a hebbian model: a randomized controlled trial. Neurorehabil Neural Repair, 2017, 31(8): 769-780.
27. Turner DL, Ramos-Murguialday A, Birbaumer N, et al. Neurophysiology of robot-mediated training and therapy:a perspective for future use in clinical populations. Front Neurol, 2013, 4: 184.
28. 張海燕, 吳方超, 李建華, 等. 上肢康復機器人輔助訓練對腦卒中患者上肢功能的影響. 中國運動醫學雜志, 2019, 38(10): 859-863.
29. 段麗麗. 上肢康復機器人對腦卒中偏癱患者上肢運動功能的影響. 臨床合理用藥雜志, 2020, 13(7): 123-124.
30. 黎祖連, 孫揚, 韓立坤, 等. 上肢機器人對腦卒中康復訓練效果的1例分析. 中國繼續醫學教育, 2019, 11(34): 158-160.
31. 朱琳, 劉霖, 宋為群. 重復性訓練對卒中患者偏癱上肢痙攣改善的療效觀察. 中國腦血管病雜志, 2007, 4(1): 18-21.
32. Vanoglio F, Bernocchi P, Mulè C, et al. Feasibility and efficacy of a robotic device for hand rehabilitation in hemiplegic stroke patients:a randomized pilot controlled study. Clin Rehabil, 2017, 31(3): 351-360.

West China Medical Journal

The effect of end-traction upper limb rehabilitation training system on upper limb motor dysfunction after stroke

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