外骨骼關節式機械手掌於中風病患指動作復健的開發及應用

腦中風──造成失能的主因之一,在如台灣高齡化中的國家,逐漸成為重要的健康議題。除了在國民健保中佔有一大比例的財務支出外,也造成個人醫療給付的額外負擔。腦中風發生後立即治療,可以迅速復原。但之後復原的機率會快速下降,幾週後復原的機會就非常低。治療慢性腦中風患者的技術領域中,已經有一些有效的方法,但都還不夠完善。許多研究指出,使用復健機器手臂對治療腦中風有正向影響。然而,這些研究參雜的變素很多,機器治療法是否比傳統治療法更加有效?還無從確認。復健機器手臂不只用來做學術研究,在多數已開發國家,也使用在臨床上。但目前台灣只有極少數的醫療設備,市面上的醫療資源也非常少。本研究的目的:使用富伯生醫科技的手部外骨骼原型,發展一套新的外骨骼機器手臂系統,並在臨床上評估其可行性與有效性。此裝置用在臨床實驗上,當作傳統治療前的誘導療法,在腦中風各療程階段中,透過高度密集的訓練,幫助病人康復。也使用在慢性腦中風患的治療上。研究成果指出,在台灣成人腦中風患者的慢性期使用這套系統,透過高強度和個人化的指部訓練,有效幫助病人肌肉運動,以及建立訓練誘發的神經可塑性,開啟了復健機器手臂新的貢獻領域。

關鍵字

康復機器人；腦中風；慢性中風；上肢康復；偏癱；肌肉運動復原

並列摘要

Cerebrovascular accident (CVA) or stroke, one of the leading causes of disability, is one of the most important health issues in Taiwan, as the Ministry of Health and Welfare (MOHW) identified aging population as their most serious challenge. Stoke is a huge financial strain on the country, as well as a heavy workload on the limited medical personnel. Stroke recovery is at its best immediately following the onset and slowing down exponentially until almost no recovery is observed within a few weeks. Several techniques have been tested to improve chronic stroke patients, however we are still looking for better solutions. Various studies and researches have shown positive outcomes to the application of robotic rehabilitation in stroke recovery. However, due to the various factors involved in the rehabilitation outcome, it is not clear what the best role of robotic rehabilitation is and in which areas it is a better option over conventional therapy. Rehabilitation robotics are not just used for research but in the clinical stage in most developed countries. However, in Taiwan, there are very few devices being used, and very few products available in the market. The aim of the thesis is to promote the use and research on robotic rehabilitation in Taiwan by developing a novel robotic hand exoskeleton system and evaluating its feasibility and efficacy in a clinical study where passive robotic therapy was used as an induction before starting conventional therapy, in order to establish the recovery benefits of providing intensive training at different stages of stroke. The study showed some additional recovery on motor learning and practice-induced neuroplasticity when used in the chronic stage of Chinese adult stroke patients, opening up a new paradigm of possible benefit of robotic rehabilitation for chronic patients.

並列關鍵字

Rehabilitation Robotics ； Stroke ； Chronic Stroke ； Upper extremity recovery ； Hemiplegia ； Motor recovery

參考文獻

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外骨骼關節式機械手掌於中風病患指動作復健的開發及應用

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