兩種上肢阻力訓練模式對慢性中風病人上肢動作功能療效之比較

Comparison of Two Resistive Arm Movement Trainings on Functional Recovery of Upper Extremity in Patients with Chronic Stroke

陳聖雄(Sheng-Shiung Chen) ； 林裕晴(Yu-Ching Lin) ； 廖麗君(Lih-Jiun Liaw) ； 歐育如(Yu-Lu Ou) ； 楊育昇(Yu-Sheng Yang) ； 張志仲(Jyh-Jong Chang)

《職能治療學會雜誌》 28卷2期 (2010/12) Pp. 16-30

https://doi.org/10.6594/JTOTA.2010.28(2).02

摘要

Patients with stroke will suffer from significant motor impairments on upper limb that drastically impacts the performance of functional abilities in activities of daily living and upper limb weakness is commonly found post-stroke. This study was to examine the effects of two resistance trainings-robot-assisted device and sanding box activity, on functional recovery of upper limb in patients with chronic stroke.
A single-blind randomized controlled trial, pre-and post-test research design was applied in this study. Thirty participants, who had unilateral strokes for at least 6 months, were enrolled in this study. Subjects were randomly assigned to one of the two training groups: the robotic-assisted group and the sanding box group. Both groups were exposed to the training for 20 minutes in a session, three sessions per week for 8 weeks.
Main outcome measurements included paretic upper-limb's muscle tone (Modified Ashworth Scale), arm movement (Stroke Rehabilitation Assessment of Movement), motor function (Action Research Arm Test and Box and Block Test) and strength (Jamar Hydraulic Hand Dynamometer and Lafayette Electronic Manual Muscle Tester).
There was no significant difference between the two groups in muscle tone, arm motor, motor function and strength. Statistically significant gains between baseline test and post-test for the robotic-assisted group were found in the Box and Block Test (F=28.76, p＜.0001, effect size: partial η^2=.69) and arm grip strength (F=13.9, p=.002, effect size: partial η^2=.50). Statistically significant gains between the baseline test and post-test for the sanding box group were found in the Box and Block Test (F=14.74, p=.004, effect size: partial η^2=.62) and elbow strength (F=14.6, p=.002, effect size: partial η^2=.52).
Both robotic-assisted and the sanding box resistive arm trainings can positively increased strength and promoted functional improvement without increasing spasticity in the study participants. These findings suggested that robotic-assisted and the sanding box training programs should be integrated as parts of rehabilitation programs.

關鍵字

中風 ； 上肢阻力訓練 ； 上肢功能 ； 復健

並列摘要

Patients with stroke will suffer from significant motor impairments on upper limb that drastically impacts the performance of functional abilities in activities of daily living and upper limb weakness is commonly found post-stroke. This study was to examine the effects of two resistance trainings-robot-assisted device and sanding box activity, on functional recovery of upper limb in patients with chronic stroke.
A single-blind randomized controlled trial, pre-and post-test research design was applied in this study. Thirty participants, who had unilateral strokes for at least 6 months, were enrolled in this study. Subjects were randomly assigned to one of the two training groups: the robotic-assisted group and the sanding box group. Both groups were exposed to the training for 20 minutes in a session, three sessions per week for 8 weeks.
Main outcome measurements included paretic upper-limb's muscle tone (Modified Ashworth Scale), arm movement (Stroke Rehabilitation Assessment of Movement), motor function (Action Research Arm Test and Box and Block Test) and strength (Jamar Hydraulic Hand Dynamometer and Lafayette Electronic Manual Muscle Tester).
There was no significant difference between the two groups in muscle tone, arm motor, motor function and strength. Statistically significant gains between baseline test and post-test for the robotic-assisted group were found in the Box and Block Test (F=28.76, p＜.0001, effect size: partial η^2=.69) and arm grip strength (F=13.9, p=.002, effect size: partial η^2=.50). Statistically significant gains between the baseline test and post-test for the sanding box group were found in the Box and Block Test (F=14.74, p=.004, effect size: partial η^2=.62) and elbow strength (F=14.6, p=.002, effect size: partial η^2=.52).
Both robotic-assisted and the sanding box resistive arm trainings can positively increased strength and promoted functional improvement without increasing spasticity in the study participants. These findings suggested that robotic-assisted and the sanding box training programs should be integrated as parts of rehabilitation programs.

並列關鍵字

stroke ； upper extremity ； resistance training of upper extremity ； functional recovery ； rehabilitation