機械輔助任務導向或損傷導向之慢性中風復健

背景與目的：中風為國人第二大死因，常伴隨動作控制障礙等問題。過去研究顯示，高密集訓練可促進中風病人動作功能恢復。機器輔助治療優點為高密度、高強度、任務專一性與使用方式彈性，但針對特定關節訓練，但對日常生活功能的提升尚無一致性結論。因此，若結合其它復健手法，如：任務導向訓練、損傷導向訓練，則能提供更全面的醫療復健。本研究目的為探討機器輔助療法合併任務導向訓練、機器輔助療法合併損傷導向訓練、常規復建訓練於慢性中風病人之成效比較。方法：受試者隨機分配到機器輔助治療合併任務導向訓練組、機器輔助治療合併損傷治療訓練組、常規復健組，接受為期4週，每週5天，每天90~95分鐘的療程。結果：目前結果顯示IMTT在上肢損傷與動作功能、降低肌肉張力、患側手於日常生活使用量、生活品質等方面最具優勢；CI組在近端肌力、日常生活獨立性等方面較有優勢。建議未來研究擴大研究樣本，拉長合併療法時間，進一步探討合併療法於中風復健之成效。

關鍵字

中風；機器輔助治療；任務導向訓練；損傷導向訓練

並列摘要

Background and purpose: Stroke is the second leading cause of death in Taiwan, usually accompanied by postured control disorder. According to past studies high intensity of training encourages stroke patient’s function recovery. Robot-assisted therapy provides high intensity, task specificity, and higher flexibility of manipulation, but specifically for joint training, and inconsistence with improvement of ADL. Hence, when combine with other approach, such as task-oriented training, impairment-oriented training, provides complete rehabilitation program. This study’s goal is to discuss the effect of robot-assisted therapy and task-oriented training combination, robot-assisted therapy and impairment-oriented training combination, regular rehabilitation training of chronic stroke patients. Methods: patients randomly distributed to IMTT group, IMTI group, and CI group, received an intervention for 4 weeks, 5 days a week, 90~95minutes per day. Results: results shows that IMTT has higher advantages in upper extremity impairment and motor function, decrease of muscle tone, impaired limb usage in daily life, and quality of life; in the other hand, CI has the higher advantage independence in daily life. Suggestion of future study is to enlarge the number of sample, higher duration of intervention, further discuss of the stroke rehabilitation outcome.

並列關鍵字

stroke ； robot-assisted therapy ； task-oriented training ； impairment-oriented training

參考文獻

Boroojerdi, B., Battaglia, F., Muellbacher, W., & Cohen, L. G. (2001). Mechanisms underlying rapid experience-dependent plasticity in the human visual cortex. Proceedings of the National Academy of Sciences, 98(25), 14698-14701. doi: 10.1073/pnas.251357198

Bosecker, C., Dipietro, L., Volpe, B., & Krebs, H. I. (2010). Kinematic robot-based evaluation scales and clinical counterparts to measure upper limb motor performance in patients with chronic stroke. Neurorehabil Neural Repair, 24(1), 62-69. doi: 10.1177/1545968309343214

Bowden, M. G., Woodbury, M. L., & Duncan, P. W. (2013). Promoting neuroplasticity and recovery after stroke: future directions for rehabilitation clinical trials. Curr Opin Neurol, 26(1), 37-42. doi: 10.1097/WCO.0b013e32835c5ba0

C.D. Takahashi, L. D.-Y., V.H. Le, S.C. Cramer (2005). A Robotic Device for Hand Motor Therapy

Casadio, M., Giannoni, P., Morasso, P., & Sanguineti, V. (2009). A proof of concept study for the integration of robot therapy with physiotherapy in the treatment of stroke patients. Clin Rehabil, 23(3), 217-228. doi: 10.1177/0269215508096759

國際替代計量

機械輔助任務導向或損傷導向之慢性中風復健

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