慢性期卒中患者上肢机器人训练前后重复测量试验中三个评估量表的响应度

The responsiveness of three assessments in repeatedly measuring upper extremity performance of chron ic stroke survivors in robotic training

目的:评价Fugl-Meyer运动功能评分上肢部分(FMA-UE)、运动功能状态量表(MSS)、上肢运动研究量表(ARAT)在重复测量慢性期卒中患者上肢功能表现方面的响应度。方法:27例慢性期卒中患者被随机分到实验组(15例)进行PolyJbot上肢机器人腕关节主动-辅助屈伸训练,对照组(12例)进行Cybex上肢机器人腕关节被动屈伸训练。被设盲的评估者对参与实验的患者分别在实验前进行两次,实验后进行一次身体结构功能及活动功能评估。主要使用的评估量表有FMA-UE、MSS、ARAT、肘和腕关节屈肌张力(MAS)、功能独立性评定(FIM)。采用重复测量方差分析检验治疗前后的治疗效果,Guyatt's响应度指数(GRI)测量各评估量表的响应度。结果:Guyyatt响应度指数显示治疗组患者的FMA-UE、FMA-UE(SE)、MSS的响应度明显大于其他量表,对照组患者的FMA-UE(SE)、MSS、MAS(W)显示较大的响应度。结论:FMA-UE和MSS在慢性期卒中上肢中度瘫痪患者,重复测试的上肢机器人腕关节训练相关试验中显示出较高的响应度。

Objective To investigate the responsiveness of Fugl-Meyer assessment upper extremity section(FMA-UE),motor status scale(MSS),action research arm test(ARAT) in repeatedly measuring upper extremity performance of chronic stroke survivors who were recited for upper extremity robotic training.Method:Twenty-seven stroke survivors were signed to either experimental group(n=15) for PolyJbot training(active-assisted wrist extension and flexion) or control group(n=12) for Cybex training(passive wrist extension and flexion).Blinded assessor evaluated the body function and activities of participants with FMA-UE,MSS,ARAT,and functional independent measure(FIM) two times pre intervention and one time post intervention.Repeated measures analysis of variance(Repeated measures ANOVA) was employed for testing the significance of changes pre and post training,and Guyyatt's responsiveness index(GRI) was used for measuring the responsiveness of the assessments.Result:GRI showed that FMA-UE,FMA-UE(SE),and MSS had relative high responsiveness in experimental group,FMA-UE(SE),MSS,MAS(W) had more sensitive responsiveness in control group.Conclusion:FMA-UE and MSS had higher responsiveness in repeatedly measuring upper extremity performance of chronic stroke survivors with moderate impaired upper limb function in robotic assisted wrist training study.