Combining Robot-Assisted Therapy With Neuro-muscular Electrical Stimulation on Sensorimotor Function, Daily Function, and Quality of Life in Patients With Stroke: A Randomized Controlled Trial
Date Issued
2014
Date
2014
Author(s)
Cheng, Hsiao-Ju
Abstract
Purpose. This study aimed to investigate the differential effects of robot-assisted therapy combined with neuro-muscular electrical stimulation (RTES), robot-assisted therapy combined with placebo-controlled stimulation (RTPS), and control treatment (CT) on sensorimotor function, daily function, and quality of life in patients with chronic stroke.
Design. A single-blinded, randomized, placebo-controlled pilot trial, with pretest and posttest measures.
Settings. Rehabilitation units in five medical centers.
Interventions. Twenty-nine participants received one of RTES, RTPS, or CT for 90-100 minutes per day, five days per week, lasting for four weeks.
Outcome measures. Primary outcomes were Action Research Arm Test (ARAT), Motor Activity Log (MAL), and Stroke Impact Scale (SIS). Secondary outcomes were revised Nottingham Sensory Assessment (RNSA), Medical Research Council scale (MRC), modified Ashworth scale (MAS), and Adelaide Activities Profile (AAP). Outcome measures for the adverse effects were Visual Analogue Scale (VAS) on pain and fatigue.
Results. There were statistically significant differences and large effects on quality of movement subscale for the ARAT (F2, 26 = 5.243, P = .013, partial η2 = .295), activities of daily living domain for the SIS (F2, 26 = 3.779, P = .037, partial η2 = .232), the MAS distal subscore (F2, 26 = 3.374, P = .050, partial η2 = .213), and the wrist flexors (F2, 26 = 4.319, P = .024, partial η2 = .257); post hoc analysis showed the RTES group was superior to the RTPS and CT groups. Despite there was no significant difference between three groups, there were large effects on ARAT pinch (F2, 26 = 2.124, P = .141, partial η2 = .145) and gross motor subscale (F2, 26 = 2.226, P = .129, partial η2 = .151), and finger flexors score of the MAS (F2, 26 = 2.491, P = .103, partial η2 = .166); it revealed that the RTES group was superior to the RTPS and CT groups. Additionally, there was moderate effects on ARAT score (F2, 26 = 1.261, P = .301, partial η2 = .092) and represented that the RTES group was superior to the RTPS and CT groups. On the other hand, there were moderate effects on ARAT grip subscale (F2, 26 = 1.038, P = .369, partial η2 = .077) and amount of use subscale for the MAL (F2, 26 = 1.526, P = .237, partial η2= .109), and it suggested that the RTES and RTPS groups were superior to the CT group. There was large effect on the SIS (F2, 26 = 2.272, P=.124, partial η2 = .154) but revealed the RTPS group improved quality of life mostly. Also, there were moderate effects on mobility subscale for the SIS (F2, 26 = 1.616, P = .219, partial η2 = .114), the AAP (F2, 26 = 1.433, P = .258, partial η2 = .103), and the degree of fatigue (F2, 26 = 1.496, P = .243, partial η2 = .107); revealed that the RTPS group had the best improvement. Surprisingly, the CT group had the best effect on tactile subscale for the RNSA (F2, 22 = 1.383, P = .273, partial η2 = .116) and proximal subscore of the MAS (F2, 26 = 3.374, P = .050, partial η2 = .213).
Conclusion. This study supports the positive effects of RT combined with NMES on fine motor function, daily function, and quality of life. For the sensory function, the CT group has the best effect than RTES and RTPS groups. Due to the small sample size in each group, the results should be interpreted carefully and need further studies to investigate.
Subjects
機器輔助療法
電刺激
中風神經復健
感覺動作功能
日常生活功能
生活品質
Type
thesis
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