[논문]Effect of robot arm reach training on upper extremity functional movement in chronic stroke survivors: a preliminary study

Cho, Ki Hun; Song, Won-Kyung

doi:10.14474/ptrs.2019.8.2.93

[국내논문] Effect of robot arm reach training on upper extremity functional movement in chronic stroke survivors: a preliminary study 원문보기

Physical therapy rehabilitation science, v.8 no.2, 2019년, pp.93 - 98

Cho, Ki Hun (Department of Physical Therapy, Korea National University of Transportation) , Song, Won-Kyung (Department of Rehabilitative and Assistive Technology, National Rehabilitation Research Institute, National Rehabilitation Center)

Abstract ▼ AI-Helper

Objective: The purpose of this study was to investigate the effect of robot arm reach training on upper extremity functional movement in chronic stroke survivors. Design: One group pretest-posttest design. Methods: Thirteen chronic stroke survivors participated in this study. Robot arm reach training was performed with a Whole Arm Manipulator (WAM) and a 120-inch projective display to provide visual and auditory feedback. During the robotic arm reach training, WAM provided gravity compensation and assist-as-needed (AAN) force according to the robot control mode. When a participant could not move the arm toward the target for more than 2 seconds, WAM provided AAN force to reach the desired targets. All patients participated in the training for 40 minutes per day, 3 times a week, for 4 weeks. Main outcome measures were the Fugl-Meyer Assessment (FMA), Action Research Arm Test (ARAT) and Box and Block Test (BBT) to assess upper extremity functional movement. Results: After 4 weeks, significant improvement was observed in upper extremity functional movement (FMA: 42.15 to 46.23, BBT: 12.23 to 14.00, p<0.05). In the subscore analysis of the FMA upper extremity motor function domains, significant improvement was observed in upper extremity and coordination/speed units (p<0.05). However, there were no significant differences in the ARAT. Conclusions: This study showed the positive effects of robot arm reach training on upper extremity functional movement in chronic stroke survivors. In particular, we confirmed that robot arm reach training could have a positive influence by leading to improvement of motor recovery of the proximal upper extremity.

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문제 정의

This was a single-group pre- and post-test design study with an aim of investigating the effect of robot arm reach training on upper extremity functional movement in chronic stroke survivors. The objectives and experimental procedures of study were explained to all the participants, and they had voluntarily signed the informed consent forms.
Thus, the purpose of the current study was to assess whether the robot arm reach training with assistance force could improve upper extremity functional movement in chronic stroke survivors. In this study, the Fugl-Meyer Assessment (FMA) subscore analysis was particularly performed to investigate the change of motor function after robot arm reach training with assistance force.

가설 설정

In this study, the Fugl-Meyer Assessment (FMA) subscore analysis was particularly performed to investigate the change of motor function after robot arm reach training with assistance force. We hypothesized that stroke survivors would show enhancements in upper extremity functional movement after 4 weeks of robot arm reach training with assistance force. The goal of present study was to provide a reference point for a future randomized controlled trial.

제안 방법

The duration of a single training session was 40 minutes with the same assistants. All participants completed the training sessions, and were assessed for functional movement using the FMA, Action Research Arm Test (ARAT) and Box and Block Test (BBT). The post-test was performed three days after the end of the intervention.
All participants participated in the training three times per week for 4 weeks. The duration of a single training session was 40 minutes with the same assistants.
While performing the robot arm reach training with an assistance force, an assistant stood nearby and emergency stop devices were installed to prevent accidents due to fatigue. All patients participated in the robotic arm training with an assistance force program for 40 minutes per day, 3 times per week, for 4 weeks.
This study has several limitations. First, since the aim of this study was to assess whether robot arm reach training with an assistance force could improve upper extremity function in chronic stroke survivors, there was no separate control group. Thus, randomized controlled trials should be performed in the future.
The post-test was performed three days after the end of the intervention. In addition, all measurements were performed by an occupational therapist and a physical therapist.
In stroke rehabilitation, providing appropriate assistance when needed is important to induce active participation [18]. In this study, when a subject could not move the arm toward the target for 2 seconds, they were provided with AAN force to reach the desired targets. Through this additional assistance force, subjects were able to maintain repeated reaching movements from the home position to the target position.
Thus, randomized controlled trials should be performed in the future. Second, this study included only high-functioning persons with stroke. Thus, the results of the current study cannot be generalized to all stroke survivors.
The ARAT is designed to evaluate upper limb functional disability through the assessment of four basic movements (primary grasp, grip, pinch, and gross movements). Each test is graded on a four-point scale, from 0 to 3, yielding a maximum score of 57 [16].
The setting of the test bed was duplicated as reported in previous studies [12-14]. The robot arm reach training with an assistance force consisted of a Whole Arm Manipulator (WAM) (Barrett Technology, Inc., Newton, MA, USA) with seven degrees of freedom and one a 120-inch projective display.

대상 데이터

Sixteen chronic stroke survivors participated in this study. Participants were recruited by the following inclusion and exclusion criteria.
Thus, it is possible to provide free motion to the user’s upper extremity in the three-dimensional space, thereby inducing coordinative movements. The WAM used in this study is an end-effector type robot and it was set at seven degrees of freedom for the shoulder, elbow, and wrist joints. Thus, it is considered that the free motion of the upper limb provided by the WAM has led to the improvement of upper extremity and coordination/speed items.
In this study, no significant improvement was observed in hand and wrist items. The participants included in this study were chronic stroke survivors (onset duration: 12 years). Most of the participants had the WAM fixated onto their hand using a strap during the robot arm reach training because they were unable to perform a hand grasp at the beginning of the study.
Setting for the robotic arm training with an assistance force program. The training test bed consisted of a Whole Arm Manipulator (WAM) and a projective display. The WAM provides a highly back-drivable motion that helps the user reach the desired sphere using point-to-point movements.

데이터처리

The Shapiro–Wilk test was used to confirm the normal distribution of all outcome variables. Since all variables were normally distributed the paired t-test was used to determine between which comparisons the differences existed. All out-comes are expressed as mean values and standard deviations.

이론/모형

The ARAT is designed to evaluate upper limb functional disability through the assessment of four basic movements (primary grasp, grip, pinch, and gross movements). Each test is graded on a four-point scale, from 0 to 3, yielding a maximum score of 57 [16].
The Shapiro–Wilk test was used to confirm the normal distribution of all outcome variables.

성능/효과

Changes in functional ability of the upper extremity. After 4 weeks of robotic arm training with an assistance force, significant improvement was observed in FMA-UE and BBT. FMA-UE: Fugl-Meyer Assessment of Upper Extremity motor function domain, BBT: Box and Block Test.
Changes in subscores of FMA upper extremity motor function. After 4 weeks of robotic arm training with an assistance force, significant improvement was observed in upper extremity and coordination/speed. FMA: Fugl-Meyer Assessment.
After 4 weeks of the robot arm reach training with an assistance force, significant improvement was observed in the FMA and BBT (FMA: 42.15 to 46.23, BBT: 12.23 to 14.00, p<0.05, Figure 3).
In conclusion, this study showed the positive effects of robot arm reach training with an assistance force on upper extremity functional movement in hemiparetic stroke survivors. In particular, it was confirmed that robot arm reach training with AAN force could positively influence the improvement of motor recovery of the proximal upper extremity proximal.

후속연구

We hypothesized that stroke survivors would show enhancements in upper extremity functional movement after 4 weeks of robot arm reach training with assistance force. The goal of present study was to provide a reference point for a future randomized controlled trial.

참고문헌 (19)

Wade, D T, Hewer, R L. Functional abilities after stroke: measurement, natural history and prognosis.. Journal of neurology, neurosurgery, and psychiatry, vol.50, no.2, 177-182.

상세보기
Stig Jørgensen, Henrik, Nakayama, Hirofumi, Raaschou, Hans Otto, Skyhøj Olsen, Tom. Stroke: Neurologic and Functional Recovery The Copenhagen Stroke Study. Physical medicine and rehabilitation clinics of North America, vol.10, no.4, 887-906.

상세보기
Kwakkel G, Kollen B, Lindeman E. Understanding the pattern of functional recovery after stroke: facts and theories. Restor Neurol Neurosci 2004;22:281-99.
10.1002/14651858.CD010820.pub2
Bayona, Nestor A., Bitensky, Jamie, Salter, Katherine, Teasell, Robert. The Role of Task-Specific Training in Rehabilitation Therapies. Topics in stroke rehabilitation, vol.12, no.3, 58-65.

상세보기
Wu, Ching-yi, Chen, Yi-an, Lin, Keh-chung, Chao, Ching-ping, Chen, Yu-ting. Constraint-Induced Therapy With Trunk Restraint for Improving Functional Outcomes and Trunk-Arm Control After Stroke: A Randomized Controlled Trial. Physical therapy, vol.92, no.4, 483-492.

상세보기
Kowalczewski, Jan, Chong, Su Ling, Galea, Mary, Prochazka, Arthur. In-Home Tele-Rehabilitation Improves Tetraplegic Hand Function. Neurorehabilitation and neural repair, vol.25, no.5, 412-422.

상세보기
Alon, Gad, Levitt, Alan F., McCarthy, Patricia A.. Functional Electrical Stimulation (FES) May Modify the Poor Prognosis of Stroke Survivors with Severe Motor Loss of the Upper Extremity: A Preliminary Study. American journal of physical medicine & rehabilitation, vol.87, no.8, 627-636.

상세보기
Veerbeek, Janne M., Langbroek-Amersfoort, Anneli C., van Wegen, Erwin E. H., Meskers, Carel G. M., Kwakkel, Gert. Effects of Robot-Assisted Therapy for the Upper Limb After Stroke : A Systematic Review and Meta-analysis. Neurorehabilitation and neural repair, vol.31, no.2, 107-121.

상세보기
Bertani, Rachele, Melegari, Corrado, De Cola, Maria C., Bramanti, Alessia, Bramanti, Placido, Calabrò, Rocco Salvatore. Effects of robot-assisted upper limb rehabilitation in stroke patients: a systematic review with meta-analysis. Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, vol.38, no.9, 1561-1569.

상세보기
Mehrholz, Jan, Platz, Thomas, Kugler, Joachim, Pohl, Marcus. Electromechanical and Robot-Assisted Arm Training for Improving Arm Function and Activities of Daily Living After Stroke. Stroke, vol.40, no.5,

상세보기
Cho, Ki Hun, Song, Won-Kyung. Robot-Assisted Reach Training for Improving Upper Extremity Function of Chronic Stroke. The Tohoku journal of experimental medicine, vol.237, no.2, 149-155.

상세보기
Cho, Ki Hun, Song, Won-Kyung. Feedback training using a non-motorized device for long-term upper extremity impairment after stroke: a single group study. Journal of physical therapy science, vol.28, no.2, 495-499.

상세보기
Cho, Ki Hun, Song, Won-Kyung. Robot-Assisted Reach Training With an Active Assistant Protocol for Long-Term Upper Extremity Impairment Poststroke: A Randomized Controlled Trial. Archives of physical medicine and rehabilitation, vol.100, no.2, 213-219.

상세보기
Sullivan, Katherine J., Tilson, Julie K., Cen, Steven Y., Rose, Dorian K., Hershberg, Julie, Correa, Anita, Gallichio, Joann, McLeod, Molly, Moore, Craig, Wu, Samuel S., Duncan, Pamela W.. Fugl-Meyer Assessment of Sensorimotor Function After Stroke : Standardized Training Procedure for Clinical Practice and Clinical Trials. Stroke, vol.42, no.2, 427-432.

상세보기
Yozbatiran, Nuray, Der-Yeghiaian, Lucy, Cramer, Steven C.. A Standardized Approach to Performing the Action Research Arm Test. Neurorehabilitation and neural repair, vol.22, no.1, 78-90.

상세보기
10.1016/0003-9993(94)90130-9 Desrosiers J, Bravo G, Hebert R, Dutil E, Mercier L. Validation of the Box and Block Test as a measure of dexterity of elderly people: reliability, validity, and norms studies. Arch Phys Med Rehabil 1994;75:751-5.

상세보기
Frisoli, Antonio, Procopio, Caterina, Chisari, Carmelo, Creatini, Ilaria, Bonfiglio, Luca, Bergamasco, Massimo, Rossi, Bruno, Carboncini, Maria Chiara. Positive effects of robotic exoskeleton training of upper limb reaching movements after stroke. Journal of neuroengineering and rehabilitation, vol.9, 36-36.

상세보기
Hsieh, Yu-wei, Lin, Keh-chung, Wu, Ching-yi, Shih, Tsai-yu, Li, Ming-wei, Chen, Chia-ling. Comparison of proximal versus distal upper-limb robotic rehabilitation on motor performance after stroke: a cluster controlled trial. Scientific reports, vol.8, 2091-.

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