BACKGROUND Our group developed a rehabilitation robot to assist with repetitive, active reaching movement of a paretic upper extremity. The robot is equipped with a servo motor-controlled arm-weight support and works in conjunction with neuromuscular electrical stimulation and vibratory stimulation to facilitate agonist-muscle contraction. In this before-and-after pilot study, we assessed the feasibility of applying the robot to improve motor control and function of the hemiparetic upper extremity in patients who suffered chronic stroke. METHODS We enrolled 6 patients with chronic stroke and hemiparesis who, while sitting and without assistance, could reach 10 cm both sagitally and vertically (from a starting position located 10 cm forward from the patient's navel level) with the affected upper extremity. The patients were assigned to receive reaching exercise intervention with the robot (Yaskawa Electric Co., Ltd. Fukuoka, Japan) for 2 weeks at 15 min/day in addition to regular occupational therapy for 40 min/day. Outcomes assessed before and after 2 weeks of intervention included the upper extremity component of the Fugl-Meyer Assessment (UE-FMA), the Action Research Arm Test (ARAT), and, during reaching movement, kinematic analysis. RESULTS None of the patients experienced adverse events. The mean score of UE-FMA increased from 44.8 [SD 14.4] to 48.0 [SD 14.4] (p = 0.026, r = 0.91), and both the shoulder-elbow and wrist-hand scores increased after 2-week intervention. An increase was also observed in ARAT score, from mean 29.8 [SD 16.3] to 36.2 [SD 18.1] (p = 0.042, r = 0.83). Kinematic analysis during the reaching movement revealed a significant increase in active range of motion (AROM) at the elbow, and movement time tended to decrease. Furthermore, trajectory length for the wrist ("hand path") and the acromion ("trunk compensatory movement") showed a decreasing trend. CONCLUSIONS This robot-assisted modality is feasible and our preliminary findings suggest it improved motor control and motor function of the hemiparetic upper extremity in patients with chronic stroke. Training with this robot might induce greater AROM for the elbow and decrease compensatory trunk movement, thus contributing to movement efficacy and efficiency. Trial registration UMIN Clinical Trial Registry, as UMIN000018132, on June 30, 2015. https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000020398.

中文翻译：

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使用新型具有臂力支撑并伴有电刺激和振动的康复机器人进行中风后慢性上肢上肢的运动：可行性试验前后。

背景技术我们的小组开发了一种康复机器人，以协助反复发作的主动上肢运动。该机器人配备了伺服电机控制的手臂支撑装置，可与神经肌肉电刺激和振动刺激结合使用，以促进激动剂-肌肉收缩。在这项前后研究中，我们评估了在患有中风的患者中使用该机器人改善运动控制和偏瘫上肢功能的可行性。方法我们招募了6例患有慢性中风和偏瘫的患者，他们在坐着而没有帮助的情况下，矢状面和垂直方向（从距患者肚脐水平10 cm处的起始位置）的矢状位和垂直位均可达10 cm，受影响的上肢。除常规的职业治疗40分钟/天外，患者还被安排接受机器人（日本福冈安川电机有限公司）的运动干预，每天15分钟/天，持续2周。干预前后2周评估的结果包括Fugl-Meyer评估（UE-FMA）的上肢部分，动作研究手臂测验（ARAT），以及在运动过程中的运动学分析。结果所有患者均未发生不良事件。UE-FMA的平均评分从44.8 [SD 14.4]增至48.0 [SD 14.4]（p = 0.026，r = 0.91），并且在两周的干预后，肩肘和腕手得分均增加。还观察到ARAT评分从平均29.8 [SD 16.3]增至36.2 [SD 18.1]（p = 0.042，r = 0.83）。伸手运动过程中的运动学分析表明，肘关节活动范围（AROM）显着增加，并且运动时间趋于减少。此外，手腕（“手部路径”）和肩峰（“躯干代偿运动”）的轨迹长度呈下降趋势。结论这种机器人辅助的方式是可行的，我们的初步发现表明，它改善了慢性卒中患者偏瘫上肢的运动控制和运动功能。用此机器人训练可能会导致肘部的AROM增大，并减少躯干的代偿性运动，从而有助于提高运动功效和效率。试验注册UMIN临床试验注册中心（UMIN000018132），于2015年6月30日。https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000020398。