Efficacy Of Upper Limb Robot-Assisted Therapy Combined With Routine Upper Limb Rehabilitation Training On Upper Limb Function In Subacute Stroke Patients

1.Background and objectivesStroke is one of the main causes of upper limb dysfunction at present.The upper limb plays an important role in our life and work.The dysfunction of the upper limb directly affects the quality of life,so improving upper limb motor function is the core element of rehabilitation.Conventional rehabilitation methods can improve upper limb motor function to some extent,but there are some drawbacks,such as it is difficult to maintain a certain training intensity in the training process,and there is no immediate feedback on the training effect and no objective evaluation data.Upper limb rehabilitation robot has the advantages of non-fatigue,quantification and individualization,which can make up for some shortcomings of conventional upper limb rehabilitation training.The effect of upper limb rehabilitation robot on the rehabilitation of upper limb function in patients with stroke recovery is unclear.Therefore,this study aims to explore the effect of upper limb rehabilitation robot training combined with conventional upper limb rehabilitation training on hemiplegic upper extremity motor function and the impact on daily living ability,and to provide the basis for clinical application of robot-assisted therapy.2.Subjects and methodsThe selected subjects with stroke were in the department of Rehabilitation Medicine and Neurosurgery,ZhuJiang hospital of Southern Medical University from October 2018 to January 2020.Subjects were selected according to the inclusion and exclusion criteria,and were randomly divided into the experimental group of 20 patients and the control group of 20 patients using the envelope method.Both groups received basic treatment.On this basis,the experimental group received upper limb robot training for 30 minutes and routine upper limb rehabilitation training for 30 minutes,while the control group received routine upper limb rehabilitation training for 60 minutes.The course of treatment in the two groups was two weeks,seven times a week and one time a day.Fugl-Meyer Assessment(upper extremity part)(FMA),Brunnstrom assessment scale(upper extremity and hand),Modified Ashworth scale(elbow flexion)(MAS)and Barthel index(BI)were used to evaluated the motor function of upper extremity and evaluated daily living ability.The sEMG data such as the root mean square(RMS)and integral electromyography(iEMG)of biceps,triceps,deltoid of anterior and middle fiber were collected to evaluate the upper limb muscle activation and synchronization of motor recruitment.SPSS 25.0 statistical software was used for statistical analysis.A bilateral test was applied and the significance level was set at P<0.05.When the measurement data conformed to normal distribution and variance homogeneous,independent sample t-test was used to the difference of measurement data between the two groups and paired t-test was used to the group before and after treatment.When the measurement data didn’t conformed to normal distribution and variance homogeneous or the data was ranked data,Wilcoxon signed-rank test was used to data between the two group and Mann-Whitney U test was used to the group before and after treatment.Enumeration data were analyzed by Chi-square test.2.ResultsA total of 38 patients completed this procedure(20 in the experimental group and 18 in the control group),and two case in the control group were detached.The FMA score(upper limb total score,shoulder and elbow,wrist and hand),BI score and Brunnstrom assessment(upper limb,hand)all improved in the two groups after training(P<0.05),but those of two groups’ MAS score was not improved after training.And the FMA score(upper limb total score,shoulder and elbow),BI score and Brunnstrom assessment(upper limb)in the experimental group was better than the control group(P<0.05).After treatment,the RMS value and iEMG value of the biceps,triceps,anterior deltoid and middle deltoid of the two groups were higher than before treatment(P<0.05).The RMS value of the triceps in the experimental group was better than the control group(P<0.05),and the RMS value and iEMG value of the middle deltoid in the experimental group were better than the control group(P<0.05).3.ConclusionUpper limb robot-assisted therapy combined with routine upper limb rehabilitation training on upper limb function in subacute stroke patient in improving upper limb motor function,improving the curative effect of daily life ability is superior to the simple routine patients with upper limb rehabilitation training,and it can promote upper limb muscle activation and motor unit recruitment synchronization,so it can be considered as an auxiliary means applied in clinical rehabilitation training.