ระบบหุ่นยนต์ WEFRE REHAB SYSTEM ช่วยการเคลื่อนไหวมือและแขนของผู้ป่วยอัมพาตแขนขาสองข้าง: การศึกษานำร่อง
ระบบหุ่นยนต์ WEFRE REHAB SYSTEM ช่วยการเคลื่อนไหวมือและแขนของผู้ป่วยอัมพาตแขนขาสองข้าง: การศึกษานำร่อง
Keywords:
robot, rehabilitation, range of motion, upper extremity, TetraplegiaAbstract
Objective: To study whether the robotic WEFRE rehab system (Wrist-Elbow-Forearm Robotic Economical Rehabilitation System) could maintain or improve passive ranges of motions
(PROMs) of the upper extremity (UE) - elbow, forearm and wrist in tetraplegic patients and replace a therapy done by a therapist.
Study design: A pilot study
Setting: Rehabilitation ward, Maharaj Hospital, Chiang Mai,Thailand
Subjects: Tetraplegic patients from spinal cord injury
Method: The arm of each participant was randomly assigned as a control or a study arm. The UE PROMs were assessed at preand post-UE rehab therapy (UERT). Each day, the control arm
was treated with two 30-minute conventional UERT by an occupational therapist (OT) whereas the study arm was treated with one 30-minute conventional and one 30-minute robotic UERTs.
After completion of the 10-day UERTs, the ROMs of the elbow, wrist, metacarpo-phalangeal (MCP) joints and forearm of each arm were compared between before and after UERTs, and between the study and the control arms. Patients’ and therapist’s satisfaction, preference and feedbacks were also reported.
Results: Six tetraplegic patients completed the study and their PROMs were analyzed. There were no statistical differences in pre-, post- and pre-post PROMs between the study and the control arms. However, there was a trend of the pre-post difference (p=0.066-0.068) in all joints tested except the wrist of the study arm, whereas only in the elbow of the control arm (p=0.066). A shoulder pain was detected after therapy in one study arm. The OT fairly agreed that the robot WEFRE rehab system could replace the conventional UERT. All participants were satisfied with the robot. Nearly all participants believed that it could replace the therapist but only one thought that a caregiver could operate it.
Conclusion: The robotic WEFRE rehab system is safe and could replace an occupational therapist for upper extremity movement therapy. Both the therapist and the patients were fairly satisfied with it. For further improvement, it should be more friendly-used and more durable.
References
Jakarta, Indonesia.
2. Biering-Sorensen F, Bryden A. Curt A, Friden J, Harvey LA, Malcahey MJ, et al. International spinal cord injury upper extremity basic Data set. Spinal Cord. 2014;52:652-7.
3. Lynskey JV, Belanger A, Jung R. Activity-dependent plasticity in spinal cord injury. J Rehabil Res Dev. 2008;45:229-40.
4. Keller U, Scholch S, Albisser U, Rudhe C, Curt A, Riener R, et al. Robot-assisted arm assessments in spinal cord injured patients: a consideration of concept study. PLoS ONE. 2015;10(5):e0126948.
5. Vanmulken DA, Spooren AI, Bongers HM, Seelen HA. Robotassisted task-oriented upper extremity skill training in cervical spinal cord injury: a feasibility study. Spinal Cord. 2015;53:547-51.
6. Chonnaparamutt W, Chanthabudsri E, Rungkao W, Sapsri W. WEFRE rehab system, presented at the CREATe ‘6th Rehabilitation Engineering & Assistive Technology Tampines, Singapore-July 24-26, 2012.
7. Zariffa J, Kapadia N, Kramer JL, Taylor P, Alizadeh-Meghrazi M, Zivanovic V, et al. Feasibility and effi cacy of upper limb robotic rehabilitation in a subacute cervical spinal cord injury population. Spinal Cord. 2012;50:220-6.