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ObjectiveTo investigate the effect of robot-assisted bilateral task-oriented upper limb training on upper limb function of patients with stroke. MethodsFrom January, 2021 to June, 2022, 52 patients with stroke in the Second Hospital of Jiaxing were enrolled and randomized into control group (n = 26) and experimental group (n = 26). Both groups received routine treatment. The control group added conventional bilateral upper limb training, while the experimental group added robot-assisted bilateral task-oriented upper limb training, for six weeks. Before and after treatment, the upper limb motor function and activities of daily living were assessed with Fugl-Meyer Assessment-Upper Extremity (FMA-UE) and modified Barthel Index (MBI). The upper limb proprioception test system was used to measure the average trace error (ATE) and test execution time of the upper limb. ResultsBefore treatment, there was no significant difference in the scores of FMA-UE and MBI, and ATE and test execution time between two groups (P > 0.05). After treatment, all the indexes improved significantly in both groups (|t| > 5.400, P < 0.001), and were better in the experimental group than in the control group (|t| > 2.123, P < 0.05). ConclusionRobot-assisted bilateral task-oriented upper limb training could facilitate to improve the upper limb motor function and activities of daily living of stroke patients.
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Background: The hand is the most active and important part of the upper extremity with complex functional biomechanics and anatomy. The decline in hand grip strength and dexterity with age can adversely affect functional activities. Task?oriented training (TOT) is a treatment approach focused on functional activities of daily life. Aim: To investigate the effect of TOT on hand dexterity, grip strength, and hand function in the geriatric population. Subjects and Methods: Sixteen institutionalized geriatric participants were recruited based on the inclusion and exclusion criteria and assigned to Group A experimental group (nine participants) who received TOT for 4 weeks, 3 days/week along with routine activities and Group B control group (seven participants) who were involved in routine activities only. Gross dexterity was assessed using the box and block test, fine dexterity with nine?hole peg board, hand grip strength with hand dynamometer, and hand function with the Michigan hand outcome questionnaire. The statistical analysis with Student’s t?test was performed using the SPSS software. The significance level kept as P ? 0.05. Results: The analysis expressed significant improvement in gross and fine hand dexterity and grip strength among the experimental group. The hand function did not reveal a statistically significant change. Conclusion: A 4?week TOT program is an effective measure to improve gross and fine dexterity, and muscle grip strength in the geriatric population. For improvement in hand function, a longer training may be required
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Objective:To observe any effect of task-oriented training in the activities of daily living (ADL) for stroke patients.Methods:Sixty-two hemiplegic stroke survivors were randomly divided into an experimental group and a control group, each of 31. In addition to routine occupational therapy, the control group exercised on their own, while the experimental group underwent 45-minute task-oriented training sessions based on ADL action analysis every day, 5 days a week for 6 weeks consecutively. Before and after the treatment the upper limb functioning of both groups was quantified using Fugl-Meyer upper limb motor function scoring (FMA-UE) and Brunnstrom staging (BSS). ADL skill was assessed using the modified Barthel index (MBI).Results:After the treatment, the average FMA-UE and MBI scores of both groups were significantly better than before the treatment and better than the control group′s averages. The average BSS scores had also improved significantly, with that of the experimental group significantly better than the control group′s average.Conclusions:Task-oriented training based on ADL motion analysis can significantly improve upper limb motor functioning and ADL ability after a stroke despite hemiplegia. Its efficacy is better than that of conventional occupational therapy alone.
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Objective:To observe the effect of a family-centered task-oriented training (TOT) program on the functional independence and life quality of children with spastic cerebral palsy.Methods:A total of 62 children with spastic cerebral palsy were randomly divided into a control group ( n=31) and a TOT group ( n=31). The children in the control group were given family rehabilitation training according to the discharge instruction manual, while the children in the TOT group received family-centered TOT. Both groups trained for 1 hour once a day, 5 days a week for 6 months. The mobility, functional independence and life quality of the two groups were evaluated with the pediatric evaluation of disability inventory (PEDI), functional independence measures for Chinese children (WeeFIM) and a pediatric quality of life inventory (PedsQL) before and after 3 and 6 months of treatment. Results:After 6 months there was significant improvement in the average mobility, WeeFIM and PedsQL scores of both groups. The average mobility, WeeFIM and PedsQL scores of the TOT group were then significantly better than those of the control group.Conclusion:Family-centered TOT training can significantly improve the functional independence and life quality of children with spastic cerebral palsy.
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Objective:To evaluate the efficacy of task-oriented training for rehabilitation of stroke patients with hemiplegia in the community.Methods:Eighty stroke patients with hemiplegia receiving rehabilitation in Shanghai Babsongyuan Subdistrict Community Health Service Center from January 2017 to December 2019 were enrolled in the study. According to the rehabilitation methods, the patients were divided into the observation group (42 cases) and the control group (38 cases). Both groups were given routine Bobath technique and motor relearning method for 3 months; on this basis the observation group was given additional task-oriented training. The Brunnstrum stage was used to evaluate the limb function, Bobath balance scale was used to evaluate the sitting and standing balance function, and modified Barthel Index (MBI) was used to evaluate the activities of daily living.Results:The Brunnstrum stage of upper limbs, hands and lower limbs, Bobath sitting and standing balance function classification and MBI score of the two groups were significantly improved after treatment (the observation group: Uc=5.037, 4.567, 5.228, 2.538, 6.508, t=36.215, P<0.05; the control group: Uc=2.483, 2.311, 2.335, 2.200, 4.102, t=29.260, P<0.05). While the Brunnstrum stage of upper limb, hand and lower limb, Bobath sitting and standing balance function grade of observation group were significantly better than those of control group, MBI score was significantly higher than that of control group ( Uc=2.592, 2.243, 2.897, 2.018, 2.825, t=8.375, P<0.05). Conclusion:Bobath technique and motor relearning method combined with task-oriented training can significantly enhance the recovery of limb motor function and the improvement of activities of daily living of stroke patients.
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OBJECTIVE@#Circuit class therapy is a cost-efficient model of treatment that can be beneficial in a setting with limited resources. Current literature has conflicting results regarding which is a more effective approach to stroke rehabilitation: focusing on functional training or on improving impairments. This pilot study provides preliminary information comparing the effects of a task-oriented versus an impairment-focused circuit class therapy on walking ability among patients with chronic stroke.@*METHOD@#Eighteen participants with a single episode of chronic stroke and limited mobility were randomized into task-oriented circuit class (task group) (n=9) and impairment-focused circuit class (impairment group) (n=9). Both groups underwent intervention thrice a week for four weeks. Blind examination was done using the Ten Meter Walk Test for comfortable gait velocity (CGV) and fast gait velocit(FGV), Time Up and Down Stairs (TUDS), and Six Minute Walk Test (6MWT).@*RESULTS@#All participants completed the treatment sessions without adverse effects. After four weeks of treatment, the task group showed statistically significant within-group change in CGV (0.12±0.08, p=0.003) and FGV (0.25±0.22, p=0.007). The impairment group only showed statistically significant improvement in 6MWT (25.80±31.2, p=0.038). There were no statistically significant changes between the groups in all outcome measures.@*CONCLUSIONS@#The preliminary data from this pilot study suggest either program can improve walking-related outcomes and may not be different, although this needs to be confirmed using an appropriately-powered trial.
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Objective: To investigate the preliminary application effect in intensive simplified home-based task-oriented training in stroke patients with unilateral lower limb motor dysfunction. Methods: From May 2016 to October 2018,30 chronic stage stroke patients with unilateral lower limb motor dysfunction for outpatient rehabilitation training at the Department of Rehabilitation Medicine,Xuanwu Hospital, Capital Medical University were enrolled retrospectively. According to the rehabilitation methods, 30 patients were divided into either a general rehabilitation training group (re = 15) or an intensive home-based task-oriented training group (re = 15). Both groups of patients underwent routine rehabilitation guidance at the rehabilitation medicine clinic (3 times a week) and intensive family rehabilitation training (2h/d) for 4 weeks. (1) The general rehabilitation training group used routine home rehabilitation training,including sloping board standing, standing up-sitting down, bending legs-stretching legs, standing forward and backward step training,and walking training under protection. The training frequency was 2 h/d,5 d/week. (2) In the family rehabilitation, the simplified task-oriented training group decomposes the " stepping" action into three exercises: ankle joint eversion, hip knee flexion with ankle dorsiflexion, hip knee extension with ankle dorsiflexion. Fugl-Meyer motor assessment-lower extremity (FMA-LE), Berg Balance Scale (BBS),Timed Up and Go (TUG) test were compared before and after treatment. Results: (1) There were significant differences in FMA-LE scores, groups and time interaction before and after treatment between the two groups (F - 483. 64, P < 0. 01). The FMA-LE scores of the general rehabilitation training group before and after treatment were 20 ± 4 and 21 ±4 respectively, while those of the simplified task-oriented training group before and after treatment were 22 ± 4 and 25 ± 6 respectively. There were no significance before treatment between the two groups (P = 0.25). After treatment, the simplified task-oriented training group was superior to the general rehabilitation training group,and the difference between both groups was statistically significant (P = 0.003). The FMA-LE scores of the two groups were better than those of the groups before treatment. The differences before and after treatment were statistically significant (all P<0.01). (2) The BBS scores before and after treatment were compared,and there was significant difference in the groups and time interaction (F = 2 375. 69, P < 0. 01). The BBS scores of the general rehabilitation training group before and after treatment were 45. 3 ± 1. 0 and 46. 4 ± 1. 3 respectively, while those of the simplified task-oriented training group before and after treatment were 46.8 ± 1.4 and 49.7 ± 1.2 respectively. There was no significant difference in BBS scores between the two groups (P =0.09). The BBS scores of the two groups were better than those of the groups before treatment, and the differences before and after treatment were statistically significant (all P<0.01). (3) There were significant differences in TUG before and after treatment in the groups and time interaction (F = 259. 56, P < 0. 01). TUG of the general rehabilitation training group before and after treatment were 20.0 ±7. 1 and 19.3 ± 7. 5 s respectively, while TUG of the simplified task-oriented training group before and after treatment were 20. 9 ± 1. 6 and 16.9 ± 1.2s respectively. There was no significant difference in TUG between the two groups (P =0.79). There was no significant difference in TUG between the general rehabilitation group before and after treatment (P = 0. 11). The TUG of the simplified task-oriented training group was shorter than that before treatment,and the difference was statistically significant before and after treatment (P<0.01). Conclusions: Intensive simplified home-based task-oriented training and intensive home-based general rehabilitation training are helpful to improve lower limb basic motor function, balance function, and motor control ability in patients with chronic lower limb motor dysfunction. Intensive simplified home-based task-oriented training is slightly superior to intensive home-based general rehabilitation training in improving basic motor function of lower limbs. The two training methods have similar effects in terms of balance function and walking speed.
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Objective To investigate the effect of transcranial direct current stimulation (tDCS) before or during task-oriented training on the upper limb dysfunction of stroke survivors.Methods Ninety stroke survivors were randomly divided into groups A,B and C,each of 30.Those in all the three groups received the same task-oriented training,but those in groups A and B received 20 minutes of tDCS of the M1 area of the cerebrum before and during the task-oriented training respectively.Group C was given placebo stimulation during the task-oriented training.The Fugl-Meyer functional upper limb assessment (FMA-UE),a Hong Kong hemiplegia upper limb function test (FTHUE-HK) and the modified Barthel index (MBI) were used to evaluate the outcomes before and after 4 weeks of treatment.Results After 4 weeks of treatment the average FMA-UE,FTHUE-HK and MBI scores of all three groups were significantly better than those before the treatment.Group B's average scores were significantly better than those of groups A and C.Conclusion tDCS significantly enhances the benefits of task-oriented training after stroke.
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Objective To investigate the effectiveness of task-oriented bilateral arm training on upper limb function in children with spastic hemiplegia. Methods 27 children within 4-6 years with spastic hemiplegic were randomly divided into control group (n=13) and experiment group (n=14). The children in control group received routine occupational therapy. The bilateral arm task-oriented training was added for children in experiment group. The Peabody development motor scale-2 (PDMS-2) and Upper Limb Physician's Rating Scale (ULPRS) were used to assess the upper limb function before and after 10 weeks intervention. Results After treatment, the scores of grasping function and visual-motor integration in PDMS-2 were significantly higher than those before treatment (P＜0.05), and the scores of experimental group werehigher than that of control group (P ＜0.05), and the difference of the added value between two groups were statistically significant (P＜0.05).The ULPRS scores of both groups increased after treatment (P＜0.05), scores between the treatment group and the control group were not statistically significant (P＞0.05), and the difference of the added value between two groups was not statistically significant (P＞0.05). Conclusion The task-oriented bilateral arm training can promote recovery for upper limb and hand function in children with spastic hemiplegia compared with routine occupational therapy.
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Objective To study the effects of the rehabilitation robot-assisted task-oriented training on the hand function in patients after stroke. Methods From June, 2015 to September, 2016, 35 inpatients suffering from stroke were randomly allocated to control group (n=17) and trial group (n=18). Based on the routine rehabilitation, the trial group accepted robot-assisted task-oriented training, while the control group accepted therapist-assisted task-oriented training, for two weeks. They were measured the active range of motion (AROM) of fingers, assessed with fingers motor of Fugl-Meyer Assessment (FMA) and modified Barthel Index (MBI) invovled with hands before and after train-ing. Results The inpatients dropped three in the control group, two in the trial group. AROM of extension and flexion of all the fingers, the AROM of extension and total of three fingers of thumb, index and middle, and the total AROM of each finger improved in the trial group af-ter training (t>2.937, P2.528, P2.535, P2.000, P2.000, P0.05). The scores of feeding, dressing, toilet transfers, bathing, groom-ing of MBI and the total score of them improved in the trial group after training (Z>2.041, P0.05). Conclusion The rehabilitation robot-assisted task-oriented training can improve AROM of hemiplegic fingers and grip function.
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Objective To investigate the effect of lower limb rehabilitation training robot combined with task-oriented training on walking ability after stroke. Methods From February 2014 to August 2015,74 consecutive patients with post-stroke who received rehabilitation therapy and met the inclusion criteria admitted to the Department of Rehabilitation Medicine,Xuanwu Hospital,Capital Medical University were collected prospectively. They were all the patients with the first-ever stroke for 1 to 12 months. They were divided into either an observation group (n = 39)or a control group (n = 35)according to whether they were treated with the lower-limb rehabilitation robot. The patients of both groups received task-oriented training,2 times a day,once for 20 min,5 days a week for 12 weeks. The observation group was also treated with the lower-limb rehabilitation training robot,1 time a day,once for 30 min,5 days a week. Berg balance scale,Fugl-Meyer assessment (FMA),timed up-and-go test (TUG)and knee flexion active range of motion (KFAROM)were used to assess the efficacy. Results (1)After treatment,the Berg scale and FMA scale scores were increased in the observation group and the control group compared with before treatment. There was significant difference (Berg scale:28 ±9 vs. 22 ±9,29 ±9 vs. 24 ±9;FMA scores:47 ± 8 vs. 36 ± 8,40 ± 6 vs. 36 ± 7;all P < 0. 01),however,there was no significant difference between the two groups (P <0. 05),and there was significant difference in FMA scores between the 2 groups (P < 0. 01 ). The differences of Berg scale scores in the observation group and the control group were 10. 75 + 0. 30 and 4. 71 + 0. 14 respectively before and after treatment. There was no significant difference between the 2 groups (t = 0. 95,P = 0. 345). The differences of FMA scores in the observation group and the control group were 5. 8 ±0. 6 and 4. 9 ±0. 8 before and after treatment (t =5. 16,P <0. 01). (2)After treatment,the tug test and KFAROM of the observation group and the control group were better than those before treatment. There were significant differences (TUG test:35 ± 13 s vs. 56 ± 18 s,53 ± 17 s vs. 58 ± 18 s;KFAROM:82 ± 24° vs. 60 ± 23°,63 ± 23° vs. 57 ± 26°;all P < 0. 01),and there were significant differences between the 2 groups (all P < 0. 01). The differences of the TUG test in the observation group and the control group before and after treatment were 21. 5 ± 5. 0 and 4. 6 ± 0. 6 s respectively. There was significant difference between the 2 groups (t = 9. 55,P < 0. 01);the differences of KFAROM in the observation group and control group before and after treatment were 5.8 ±0.6° vs. 4.9 ±0.8° respectively. There was significant differences between the 2groups (t =4.17,P <0. .01). Conclusion Lower limb rehabilitation training robot combined with task-oriented training may improve the lower extremity motor function,walking ability,knee flexion joint activity of the patients after stroke,but the improvement effect of the lower limb balance is not obvious.
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@#Objective To investigate the effects of mirror visual feedback (MVF) and electromyographic biofeedback (EMGBF) on upper extremity function in hemiplegic patients after stroke based on task-oriented training. Methods 90 patients with hempiplegia after stroke were randomly divided into control group (n=30), EMGBF group (n=30) and MVF group (n=30). All patients accepted routine rehabilitation and task-oriented training once a day for 8 weeks. The EMGBF group also accepted EMGBF, and the MVF group accepted MVF in addition. They were assessed with Fugl-Meyer Assessment (FMA) and the Upper Extremity Function Test (UEFT), and their integrated electromyogram (iEMG) of affected upper extremities were recorded before and after treatment. Results All the groups improved in scores of FMA and UEFT, as well as the iEMG after treatment (P<0.05), and ranked as the MVF group, the EMGBF group and the control group from improving more to less (P<0.05). Conclusion Mirror visual feedback combined with electromyographic biofeedback may further promote the recovery of upper limb function in patients with hemiplegia after stroke based on task-oriented training.
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Objective To investigate the effects of mirror visual feedback (MVF) and electromyographic biofeedback (EMGBF) on up-per extremity function in hemiplegic patients after stroke based on task-oriented training. Methods 90 patients with hempiplegia after stroke were randomly divided into control group (n=30), EMGBF group (n=30) and MVF group (n=30). All patients accepted routine rehabilitation and task-oriented training once a day for 8 weeks. The EMGBF group also accepted EMGBF, and the MVF group accepted MVF in addi-tion. They were assessed with Fugl-Meyer Assessment (FMA) and the Upper Extremity Function Test (UEFT), and their integrated electro-myogram (iEMG) of affected upper extremities were recorded before and after treatment. Results All the groups improved in scores of FMA and UEFT, as well as the iEMG after treatment (P<0.05), and ranked as the MVF group, the EMGBF group and the control group from im-proving more to less (P<0.05). Conclusion Mirror visual feedback combined with electromyographic biofeedback may further promote the recovery of upper limb function in patients with hemiplegia after stroke based on task-oriented training.
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@#Objective To investigate the effects of mirror visual feedback (MVF) and electromyographic biofeedback (EMGBF) on upper extremity function in hemiplegic patients after stroke based on task-oriented training. Methods 90 patients with hempiplegia after stroke were randomly divided into control group (n=30), EMGBF group (n=30) and MVF group (n=30). All patients accepted routine rehabilitation and task-oriented training once a day for 8 weeks. The EMGBF group also accepted EMGBF, and the MVF group accepted MVF in addition. They were assessed with Fugl-Meyer Assessment (FMA) and the Upper Extremity Function Test (UEFT), and their integrated electromyogram (iEMG) of affected upper extremities were recorded before and after treatment. Results All the groups improved in scores of FMA and UEFT, as well as the iEMG after treatment (P<0.05), and ranked as the MVF group, the EMGBF group and the control group from improving more to less (P<0.05). Conclusion Mirror visual feedback combined with electromyographic biofeedback may further promote the recovery of upper limb function in patients with hemiplegia after stroke based on task-oriented training.
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Objective To study the effects of task-oriented training combined with electromyographic biofeedback on wrist and finger extension after stroke.Methods Thirty-eight stroke patients were assigned randomly into either an experimental group (18 cases) or a control group (18 cases).Both groups received routine rehabilitation treatment and electromyographic biofeedback training.In addition,the experimental group was given task-oriented training in wrist and finger extension.Myoelectricity values,the active range of wrist dorsiflexion and the FuglMeyer upper extremity assessment (FMA) were assessed before and after 8 weeks of training.Results All of the patients showed significant improvements after 8 weeks of training,but compared with the controls,the patients in the experimental group improved significantly more in terms of all of the measures.Conclusion Task-oriented training with electromyographic biofeedback can improve upper extremity function,particularly wrist extension,among hemiplegic stroke survivors.
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Objective To explore the effect of mirror therapy in conjunction with task-oriented training on the upper extremity function of post-stroke patients and the possible mechanisms. Methods Twenty-one post-stroke patients were randomly assigned to a treatment group (10 patients) or a control group (ll patients).The patients in the treatment group were given conventional rehabilitation therapy and mirror therapy in conjunction with task-oriented training for 4 weeks.The control group was given only the same conventional rehabilitation treatment as the treatment group and upper extremity task-oriented training for 4 weeks.Both groups trained 1 h/d,5 d/week.Upper-extremity motor ability was assessed using the Fugl-Meyer assessment (FMA) and the Hong Kong version of the functional test for the hemiplegic upper extremity (FTHUE-HK).Ability in the activities of daily living (ADL) was assessed using the Barthel Index (BI) pre-treatment and after 2 and 4 weeks of treatment. Results At the 2nd week and 4th week evaluations,the FMA,FTHUE-HK and BI scores in both groups had all significantly increased compared with pretreatment.The average FMA score in the treatment group increased significantly more than in the control group at week 2,but by the 4th week both FMA and FTHUE-HK scores in the treatment group significantly exceeded those in the control group.There was no significant difference between the two groups in the improvement of their average BI scores. Conclusions Implementing mirror therapy in conjunction with task-oriented training is efficacious.It may promote upper-extremity motor ability in patients with hemiparesis soon after stroke,but there is no definite improvement in ADL ability.
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0.05).The score of GMFM-66(55.24?11.68)after treatment had obviously improved as compared with that before treatment(39.81?13.17)in the observation group(P=0),and the score of GMFM-66(48.76?11.96)after treatment had obviously improved as compared with that before treatment(40.25?12.89)in the control group(P=0.010 3),and the effect of the observation group was significantly superior to that of control group(P=0.038 0).Conclusion ESFN combined with TOT can effectively improve the motor function in children with cerebral palsy.