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, Jääskö 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.	闵瑜, 燕铁斌. 改良Barthel指数表及其评分标准. 广东省康复医学会会刊, 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.
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20.	宋迪, 吴军发. 基因对脑卒中后神经可塑性的影响以及在精准康复中的作用. 中华物理医学与康复杂志, 2018, 40(9): 712-715.
21.	杨颐, 王雪飞, 王麟鹏. 神经可塑性与脑卒中后运动功能恢复. 中国医刊, 2016, 51(6): 15-19.
22.	李庆玲. 基于sEMG信号的外骨骼式机器人上肢康复系统研究. 哈尔滨工业大学, 2009.
23.	Balasubramanian S, Klein J, Burdet E. Robot-assisted rehabilitation of hand function. Curr Opin Neurol, 2010, 23(6): 661-670.
24.	曹明辉, 燕军, 燕铁斌, 等. MOTOmed不同模式运动训练对青年志愿者体感诱发电位的影响. 中华物理医学与康复杂志, 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.	张海燕, 吴方超, 李建华, 等. 上肢康复机器人辅助训练对脑卒中患者上肢功能的影响. 中国运动医学杂志, 2019, 38(10): 859-863.
29.	段丽丽. 上肢康复机器人对脑卒中偏瘫患者上肢运动功能的影响. 临床合理用药杂志, 2020, 13(7): 123-124.
30.	黎祖连, 孙扬, 韩立坤, 等. 上肢机器人对脑卒中康复训练效果的1例分析. 中国继续医学教育, 2019, 11(34): 158-160.
31.	朱琳, 刘霖, 宋为群. 重复性训练对卒中患者偏瘫上肢痉挛改善的疗效观察. 中国脑血管病杂志, 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. 国家卫生和计划生育委员会. 中国卫生和计划生育统计年鉴2017. 北京: 中国协和医科大学出版社, 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. 中华神经科学会. 各类脑血管疾病诊断要点. 中华神经科杂志, 1996, 29(6): 379-380.
10. 王玉龙. 康复功能评定学. 北京: 人民卫生出版社, 2008: 164-168.
11. 中华医学会神经病学分会, 中华医学会神经病学分会脑血管病学组. 中国急性缺血性脑卒中诊治指南2018. 中华神经科杂志, 2018, 51(9): 666-682.
12. 李响, 张洪蕊, 杨宪章, 等. 以任务目标为导向的上肢功能训练对卒中患者日常生活活动能力的影响. 中国康复医学杂志, 2017, 32(10): 1180-1182.
13. Fugl-Meyer AR, Jääskö 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. 闵瑜, 燕铁斌. 改良Barthel指数表及其评分标准. 广东省康复医学会会刊, 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, 吴军发. 基因对脑卒中后神经可塑性的影响以及在精准康复中的作用. 中华物理医学与康复杂志, 2018, 40(9): 712-715.
21. 杨颐, 王雪飞, 王麟鹏. 神经可塑性与脑卒中后运动功能恢复. 中国医刊, 2016, 51(6): 15-19.
22. 李庆玲. 基于sEMG信号的外骨骼式机器人上肢康复系统研究. 哈尔滨工业大学, 2009.
23. Balasubramanian S, Klein J, Burdet E. Robot-assisted rehabilitation of hand function. Curr Opin Neurol, 2010, 23(6): 661-670.
24. 曹明辉, 燕军, 燕铁斌, 等. MOTOmed不同模式运动训练对青年志愿者体感诱发电位的影响. 中华物理医学与康复杂志, 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. 张海燕, 吴方超, 李建华, 等. 上肢康复机器人辅助训练对脑卒中患者上肢功能的影响. 中国运动医学杂志, 2019, 38(10): 859-863.
29. 段丽丽. 上肢康复机器人对脑卒中偏瘫患者上肢运动功能的影响. 临床合理用药杂志, 2020, 13(7): 123-124.
30. 黎祖连, 孙扬, 韩立坤, 等. 上肢机器人对脑卒中康复训练效果的1例分析. 中国继续医学教育, 2019, 11(34): 158-160.
31. 朱琳, 刘霖, 宋为群. 重复性训练对卒中患者偏瘫上肢痉挛改善的疗效观察. 中国脑血管病杂志, 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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