Background. High-intensity repetitive training is challenging to provide poststroke. Robotic approaches can facilitate such training by unweighting the limb and/or by improving trajectory control, but the extent to which these types of assistance are necessary is not known. Objective. The purpose of this study was to examine the extent to which robotic path assistance and/or weight support facilitate repetitive 3D movements in high functioning and low functioning subjects with poststroke arm motor impairment relative to healthy controls. Methods. Seven healthy controls and 18 subjects with chronic poststroke right-sided hemiparesis performed 300 repetitions of a 3D circle-drawing task using a 3D Cable-driven Arm Exoskeleton (CAREX) robot. Subjects performed 100 repetitions each with path assistance alone, weight support alone, and path assistance plus weight support in a random order over a single session. Kinematic data from the task were used to compute the normalized error and speed as well as the speed-error relationship. Results. Low functioning stroke subjects (Fugl-Meyer Scale score = 16.6 ± 6.5) showed the lowest error with path assistance plus weight support, whereas high functioning stroke subjects (Fugl-Meyer Scale score = 59.6 ± 6.8) moved faster with path assistance alone. When both speed and error were considered together, low functioning subjects significantly reduced their error and increased their speed but showed no difference across the robotic conditions. Conclusions. Robotic assistance can facilitate repetitive task performance in individuals with severe arm motor impairment, but path assistance provides little advantage over weight support alone. Future studies focusing on antigravity arm movement control are warranted poststroke.

中文翻译：

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机器人路径辅助和重量支撑在促进卒中后偏瘫患者 3D 运动中的作用

背景。高强度重复训练对提供中风后训练具有挑战性。机器人方法可以通过减轻肢体的重量和/或改善轨迹控制来促进这种训练，但这些类型的辅助在多大程度上是必要的尚不清楚。客观的。本研究的目的是检查机器人路径辅助和/或重量支持在多大程度上促进了高功能和低功能受试者相对于健康对照组的中风后手臂运动障碍的重复 3D 运动。方法。7 名健康对照者和 18 名患有慢性卒中后右侧偏瘫的受试者使用 3D 电缆驱动臂外骨骼 (CAREX) 机器人执行了 300 次重复的 3D 画圆任务。受试者单独进行 100 次重复，每次仅使用路径辅助、单独的重量支撑、和路径辅助以及在单个会话中随机顺序的重量支持。来自任务的运动学数据用于计算归一化误差和速度以及速度-误差关系。结果。低功能中风受试者（Fugl-Meyer 量表评分 = 16.6 ± 6.5）显示路径辅助加重量支持的误差最低，而高功能中风受试者（Fugl-Meyer 量表评分 = 59.6 ± 6.8）仅在路径辅助下移动速度更快。当同时考虑速度和错误时，低功能受试者显着减少了他们的错误并提高了他们的速度，但在机器人条件下没有表现出差异。结论。机器人辅助可以促进严重手臂运动障碍个体的重复性任务表现，但路径辅助与单独的重量支撑相比几乎没有优势。