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标题：A new treatment in the rehabilitation of the paretic upper limb after stroke: the ARAMIS prototype and treatment protocol Loris Pignolo, Lucia F. Lucca, Giuseppina Basta, Sebastiano Serra, Maria E. Pugliese, Walter G. Sannita and Giuliano Dolce
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作者：Loris Pignolo ; Lucia F. Lucca ; Giuseppina Basta 等
期刊名称：Annali dell'Istituto Superiore di Sanita
印刷版ISSN：0021-2571
出版年度：2016
卷号：52
期号：2
页码：301-308
DOI：10.4415/ANN_16_02_25
出版社：Editrice Kurtis Srl
摘要：Background. In recent years, as part of the rehabilitation of post stroke patients, the useof robotic technologies to improve recovery of upper limb has become more widespread.The Automatic Recovery Arm Motility Integrated System (ARAMIS) is a concept robotand prototype designed to promote the functional interaction of the arms in theneurorehabilitation of the paretic upper limb. Two computer-controlled, symmetric andinteracting exoskeletons compensate for the inadequate strength and accuracy of theparetic arm and the effect of gravity during rehabilitation. Rehabilitation is possible in 3different modalities; asynchronous, synchronous and active-assisted.Objectives. To compare the effectiveness of robotic rehabilitation by an exoskeletonprototype system with traditional rehabilitation in motor and functional recovery of theupper limb after stroke.Methods. Case-control study, 52 patients enrolled in the study, 28 cases (women: 8, age:65 ± 10 yrs) treated with ARAMIS and 24 controls (women: 11, age: 69 ± 7 yrs) withconventional rehabilitation.Motor impairment assessed before and after treatment with Fugl-Meyer scale andMotricity Index, level of disability assessed with the Functional Independence Measure.A questionnaire was also administered to assess the patient’s tolerance to robotic therapy.Results. After 28 ± 4 sessions over a 54 ± 3.6-day period, the patients treated by ARAMIShad an improvement on the Fugl-Meyer scale (global score from 43 ± 18 to 73 ± 29;p < 0.00001), Motricity Index scale (p < 0.004) and Functional Independence Measure(p < 0.001). A lesser degree of improvement was achieved using conventional rehabilitation,the Fugl-Meyer global score of the control group improved from 41 ± 13 to 58 ± 16(p < 0.006) and the motor function item from 9.4 ± 4.1 to 14.9 ± 5.8 (p < 0.023).Conclusions. Motor improvement was greater at the wrist and hand than at shoulderand elbow level in patients treated by ARAMIS and controls, but it was significantlygreater in ARAMIS-treated patients than in controls. The results indicate a greater efficacyof ARAMIS compared to conventional rehabilitation.
关键词：robotic; stroke; paretic upper limb; rehabilitation; motor recovery