機器輔助療法於中風復健之成效：隨機控制試驗之系統回顧

目的：應用機器輔助療法於中風復健治療的隨機臨床試驗逐年漸增，但尚乏系統回顧來整合相關研究證據。本文透過系統回顧，整合機器輔助療法之隨機控制試驗，以分析該療法於中風復健之成效。方法：檢索電子資料庫中1950年至2009年5月發表之論文，並搜尋其他回顧及相關論文之參考文獻，檢索出以機器輔助療法為治療，上肢動作功能；日常生活功能為依變項之等劑量隨機控制臨床試驗並計算效果值。結果：共收錄11篇適用論文，結果顯示機器輔助療法在上肢近端動作功能及肌肉力量上優於等劑量之控制組，呈現中至高度效應。在上肢遠端功能及日常生活功能上，機器輔助療法呈現低度至中高度不等之優勢。結論：機器輔助療法較之其它等劑量復健治療，能改善中風個案上肢近端動作功能與肌肉力量。日常功能方面，則未有充分證據支持機器輔助療法之優勢。未來可透過更大的臨床試驗來釐清機器輔助療法的成效，並探討可能影響成效的因素（如治療密集度），以發展具實證基礎之復健介入。

關鍵字

機器輔助療法；中風復健；動作功能；日常生活功能；實證治療

並列摘要

Objectives: Randomized controlled trials that investigated the effects of robot-assisted therapy (RAT) in stroke survivors have accumulated in recent years. But yet no systematic review has been reported that focused on the effects of RAT relative to control treatments. This study reported quantitative results of a systematic review that included 11 RCTs comparing RAT to active control interventions after stroke. Methods: Articles published between 1950 and May 2009 were retrieved from electronic databases and manual search. References of relevant articles were also reviewed. The independent variable of interest was stroke rehabilitation (i.e., RAT vs. control treatment). The dependent variables included measures of motor function, muscle function, activities of daily living and quality of life. To be eligible for inclusion, the design of the studies must be randomized controlled trials with active controls. The effect size estimates were calculated for each of the outcome measures of the included studies. Results: Eleven articles were eligible for inclusion. The results showed that RAT improved performance on motor function of the proximal paretic limb and muscle strength more than control interventions, with moderate-to-large effect sizes. A large variability was found in motor function of the distal paretic limb and daily functions (low-to-moderate effect sizes). Conclusions: RAT was more effective than control therapies in improving motor function of the proximal paretic limb and muscle strength. Benefits of RAT for enhancing daily functions were less conclusive. Future research should use larger sample sizes to investigate the effects of RAT on functional outcomes and study moderating factors (e.g., treatment intensity and task specificity).

並列關鍵字

Robotic rehabilitation ； Stroke ； Systematic review ； Evidence-based practice

國際替代計量

機器輔助療法於中風復健之成效：隨機控制試驗之系統回顧

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