Effectiveness Of Assisted Task-oriented Training On Hand Function Recovery In Patients With Stroke

ObjectiveThe purpose of this study was to clear the effectiveness of the Robot-Assisted(Gloreha2)Grasping task-oriented training on hand function recovery in patients with 1-6 months stroke,under the guidance of the Person-Environment-Occupation Model.Methods40 stroke patients who were receiving treatment in the rehabilitation department in the Second Affiliated Hospital of Guangzhou Medical University were recruited during July 2015 to November 2016,and randomly allocated into the Trial group(21patients)and the Control group(19 patients).All patients were treated with basic medicine and conventional rehabilitation training;In addition,the Robot-Assisted task-oriented training was carried out in the Trail group,and the rehabilitation therapist assisted training was implemented in the Control group.The fingers Active Range of Motion,Fugl-Meyer Assessment,Lindmark Assessment and Modified Barthel Index were evaluated before and after the treatment.Data of the trial was analysed with SPSS 22.0.Results1.AROM: The AR OM of extension,flexion and TROM of all fingers and the three fingers(thumb,index and middle),the AROM of extension,flexion and TROM of the thumb,index and ring finger,the AROM of extension and TROM showeddifference between groups after treatment,the trail group was better than control group;While,the AROM of extension of middle and little finger,flexion and TROM of little finger were no difference.The AROM of extension,flexion and TROM of all fingers,three fingers(thumb,index and middle)and each finger showed difference before and after treatment in Trail group.In Control group,the AROM of extension,flexion and TROM of all fingers and three fingers,the AROM of extension of thumb,index and little finger,flexion of thumb,index,middle and ring finger,and TROM of each finger showed difference,while the AROM of extension of middle and ring finger,and flexion of little finger were no difference before and after treatment.2.FMA: The score of mass extension,cylinder and spherical grip in Trial group was higher than Control group after treatment and showed difference,while the mass flexion,hook grip,thumb adduction,opposition and total score of the seven items were no difference between groups after treatment.The score of mass extension,mass flexion,opposition,hook,spherical and cylinder grip and total score of sveven items in the Trial group and mass flexion,hook and spherical grip,opposition,and total score of seven items in the Control group showed difference before and after treatment,while,other items in each were no changing.3.Lindmark: The score of mass flexion,cylinder and spherical grip and total score of seven items in the Trial group was higher than the Control group after treatment and showed difference,while,the mass extension,hook grip,thumb adduction and opposition were no difference between groups after treatment.The score of mass flexion,mass extension,hook,cylinder and spherical grip and total score in the Trial group and the hook grip and total score in the Control group showed difference before and after treatment,while,other items were not.4.MBI: Every item and total score in the MBI were no difference between groups after treatment;The feeding,dressing,toilet transfers,bathing,grooming,ambulation and total score in the Trial group and the dressing,toilet transfers score in the Control group showed difference before and after treatment,while,other item in each group not improved.5.Correlation analysis of FMA、Lindmark and MBI: The improvement of FMA total scale was relevant to the progress of the item of dressing and toilet transfers in MBI(p<0.05),the correlation coefficient was 0.648 and 0.515;The improvement of FMA and Lindmark total scale was linked to the total scale of MBI(p<0.05),and the the correlation coefficient was 0.494 and 0.596.Conclusion1.The Robot-Assisted task-oriented training were useful for the hand function recovery in the patients with early stroke,especially in the movement of hand,cylinder and spherical grip.2.The ability of Activity of Daily Life in patients with stroke was improved after the assisted task-oriented training.3.Assistant task oriented training under the guidance of the theory of PEO model was effective in rehabilitation of hand function after stroke at early stage.