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A Robotic System with EMG-Triggered Functional Eletrical Stimulation for Restoring Arm Functions in Stroke Survivors
Neurorehabilitation and Neural Repair ( IF 4.2 ) Pub Date : 2021-03-03 , DOI: 10.1177/1545968321997769
Emilia Ambrosini 1 , Giulio Gasperini 2 , Johannes Zajc 3 , Nancy Immick 4 , Andreas Augsten 4 , Mauro Rossini 2 , Roberto Ballarati 2 , Micheal Russold 3 , Simona Ferrante 1 , Giancarlo Ferrigno 1 , Maria Bulgheroni 5 , Walter Baccinelli 5 , Thomas Schauer 6 , Constantin Wiesener 6 , Margit Gfoehler 7 , Markus Puchinger 7 , Mathias Weber 8 , Sebastian Weber 8 , Alessandra Pedrocchi 1 , Franco Molteni 2 , Karsten Krakow 4
Affiliation  

Background

Robotic systems combined with Functional Electrical Stimulation (FES) showed promising results on upper-limb motor recovery after stroke, but adequately-sized randomized controlled trials (RCTs) are still missing.

Objective

To evaluate whether arm training supported by RETRAINER, a passive exoskeleton integrated with electromyograph-triggered functional electrical stimulation, is superior to advanced conventional therapy (ACT) of equal intensity in the recovery of arm functions, dexterity, strength, activities of daily living, and quality of life after stroke.

Methods

A single-blind RCT recruiting 72 patients was conducted. Patients, randomly allocated to 2 groups, were trained for 9 weeks, 3 times per week: the experimental group performed task-oriented exercises assisted by RETRAINER for 30 minutes plus ACT (60 minutes), whereas the control group performed only ACT (90 minutes). Patients were assessed before, soon after, and 1 month after the end of the intervention. Outcome measures were as follows: Action Research Arm Test (ARAT), Motricity Index, Motor Activity Log, Box and Blocks Test (BBT), Stroke Specific Quality of Life Scale (SSQoL), and Muscle Research Council.

Results

All outcomes but SSQoL significantly improved over time in both groups (P < .001); a significant interaction effect in favor of the experimental group was found for ARAT and BBT. ARAT showed a between-group change of 11.5 points (P = .010) at the end of the intervention, which increased to 13.6 points 1 month after. Patients considered RETRAINER moderately usable (System Usability Score of 61.5 ± 22.8).

Conclusions

Hybrid robotic systems, allowing to perform personalized, intensive, and task-oriented training, with an enriched sensory feedback, was superior to ACT in improving arm functions and dexterity after stroke.



中文翻译:

一种具有 EMG 触发功能性电刺激的机器人系统,用于恢复中风幸存者的手臂功能

背景

机器人系统与功能性电刺激 (FES) 相结合,在中风后上肢运动恢复方面显示出有希望的结果,但仍然缺少足够规模的随机对照试验 (RCT)。

客观的

评估由 RETRAINER 支持的手臂训练,一种与肌电图触发的功能性电刺激相结合的被动外骨骼,在手臂功能、灵活性、力量、日常生活活动的恢复方面是否优于同等强度的高级常规疗法 (ACT)中风后的生活质量。

方法

进行了一项招募 72 名患者的单盲 RCT。患者随机分为 2 组,训练时间为 9 周,每周 3 次:实验组在 RETRAINER 辅助下进行任务导向练习 30 分钟加 ACT(60 分钟),而对照组仅进行 ACT(90 分钟) )。在干预结束前、结束后不久和结束后 1 个月对患者进行评估。结果测量如下:动作研究手臂测试 (ARAT)、运动指数、运动活动日志、箱式和块式测试 (BBT)、中风特定生活质量量表 (SSQoL) 和肌肉研究委员会。

结果

除 SSQoL 外,两组的所有结局均随时间显着改善(P < .001);发现 ARAT 和 BBT 有利于实验组的显着交互作用。ARAT 显示干预结束时的组间变化为 11.5 分 ( P = .010),1 个月后增加至 13.6 分。患者认为 RETRAINER 中等可用(系统可用性评分为 61.5 ± 22.8)。

结论

混合机器人系统允许执行个性化、密集和以任务为导向的训练,具有丰富的感官反馈,在改善中风后的手臂功能和灵巧性方面优于 ACT。

更新日期:2021-03-03
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