Article

Augmented physical training with assistance from robot and
neuromuscular electrical stimulation (NMES) may introduce intensive motor
improvement in chronic stroke. OBJECTIVE: To compare the rehabilitation
effectiveness achieved by NMES robot-assisted wrist training and that by
robot-assisted training. METHODS: This study was a single-blinded randomized
controlled trial with a 3-month follow-up. Twenty-six hemiplegic subjects with
chronic stroke were randomly assigned to receive 20-session wrist training with
an electromyography (EMG)-driven NMES robot (NMES robot group, n = 11) and with
an EMG-driven robot (robot group, n = 15), completed within 7 consecutive weeks.
Clinical scores, Fugl-Meyer Assessment (FMA), Modified Ashworth Score (MAS), and
Action Research Arm Test (ARAT) were used to evaluate the training effects before
and after the training, as well as 3 months later. An EMG parameter, muscle
co-contraction index, was also applied to investigate the session-by-session
variation in muscular coordination patterns during the training. RESULTS: The
improvement in FMA (shoulder/elbow, wrist/hand) obtained in the NMES robot group
was more significant than the robot group (P < .05). Significant improvement in
ARAT was achieved in the NMES robot group (P < .05) but absent in the robot
group. NMES robot-assisted training showed better performance in releasing muscle
co-contraction than the robot-assisted across the training sessions (P < .05).
CONCLUSIONS: The NMES robot-assisted wrist training was more effective than the
pure robot. The additional NMES application in the treatment could bring more
improvements in the distal motor functions and faster rehabilitation progress.
CI - (c) The Author(s) 2014.

Langue : ANGLAIS