| Summary: | 博士 === 國立成功大學 === 醫學工程研究所碩博士班 === 94 === Patients with stroke often remain affected upper limb motor impairment and demonstrate disability in performing activities of daily living. Due to the growth of neuroscience, the relationships between brain reorganization and therapy-induced motor recovery have been further explored. Thus, the development of evaluation and therapeutic modality, based on neuroscience evidence, for the interventions of paretic upper motor recovery will contribute to the recovery of motor function, and consequently increase the quality of life for patients with stroke.
The primary purposes of this study are to analyze the constructs of kinematic measure in reaching, and to establish a kinematic model for discriminating normal and abnormal reaching. Besides, this study will design a purpose-built robot-aided bilateral force-induced isokinetic arm movement trainer for stroke upper limb motor rehabilitation. Then, we will further analyze the effects of our robot-aided device training on the paretic upper limb motor recovery for patients with chronic stroke.
Findings in this study showed that the kinematic reaching variables could be categorized into two common factors. Common factor I reflected the characteristics related to movement speed and smoothness, and common factor II reflected the characteristics related to motor control strategy in reaching. Variables loading on common factor I were significantly correlated with the clinical motor assessment scales (Fugl-Meyer motor assessment, Modified Ashworth scale), Peak velocity and number of movement unit can be used to established a parsimony model for discriminating between normal and abnormal reaching. Furthermore, our results showed interlimb coupling effect did not benefit the quality of motor control during bilateral reaching. It is hypothesized bilateral reaching was more attention demanded and challenge to patients with chronic stroke as compared to unilateral reaching.
Additionally, this study developed a robot-aided bilateral force-induced isokinetic arm movement trainer. A preliminary subject reports from the stroke subjects after 8 week’s training demonstrated improvements in strength, motor function, stability, muscle tone, tremor, hand dexterity and edema were reported. Further quantitative measures with pr-post and retention research design showed strength, motor function, and reaching performance were significantly improved after 8 weeks’ training. From the retention tests, the remaining effects only presented in strength and motor function but not in reaching kinematics.
This study developed a kinematic model and robot-aided device for the assessment and treatment of the paretic upper limb motor function for patients with stroke. These findings could be exploited to the clinical settings for stroke rehabilitation. The robot-aided device could also be applied to the long-term care and home care settings for maintaining and improving the paretic upper limb motor function for patients with chronic stroke.
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