Efekt bimanuální senzorické rukavice a unimanuální roboticky asistované terapie na funkci horní končetiny po cévní mozkové příhodě

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Authors: K. Hoidekrová ^1-3; V. Rogalewicz ¹; M. M. Jahromi ⁴; M. Sobrova ²; D. Pavlů ³
Authors‘ workplace: Department of Rehabilitation Medicine, First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic ¹; Kladruby Rehabilitation Centre, Kladruby u Vlašimi, Czech Republic ²; Department of Physiotherapy, Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic ³; Third Faculty of Medicine, Charles University, Prague, Czech Republic ⁴
Published in: Cesk Slov Neurol N 2024; 87(2): 114-121
Category: Original Paper
doi: https://doi.org/10.48095/cccsnn2024114

Overview

Úvod: Porucha funkce horní končetiny u pacientů po CMP významně ovlivňuje provádění běžných denních činností (activities of daily living; ADL). Většina ADL je bimanuální, zatímco mnoho konvenčních ergoterapeutických technik je založeno na unimanuálním přístupu. Cílem studie je porovnat dlouhodobé účinky bimanuální a unimanuální roboticky asistované terapie na funkci horní končetiny u pacientů po CMP. Metoda: Pacienti po CMP (n = 40) byli náhodně rozděleni do dvou skupin: roboticky asistovaná bimanuální terapie (BRAT, n = 20) a roboticky asistovaná unimanuální terapie (URAT, n = 20). Terapie trvala 3 týdny a probíhala 5 dní v týdnu, 30 min denně pro obě skupiny. Výsledky intervence byly hodnoceny pomocí Upper Extremity Motor Activity Log (UE MAL) a Motor Assessment Scale (MAS) v časech T0, T1 a T2 (jednoměsíční sledování). K posouzení svalové síly byl použit Motricity Index (MI). Výsledky: BRAT statisticky významně zlepšila funkci horní končetiny v kategorii 7-Hand motion (v T2) a 8-Advantage hand motion (v T1 a T2) dle MAS. Závěr: BRAT má pozitivní vliv na jemnou motoriku a funkci horní končetiny po dokončení terapie a dokonce i po jednoměsíčním sledování. Použití BRAT v kombinaci s konvenční terapií může být účinné při obnově funkce horní končetiny u pacientů po cévní mozkové příhodě se středně těžkou až těžkou hemiparézou.

Klíčová slova:

cévní mozková příhoda – hemiparéza – rehabilitace – senzorická rukavice – běžné denní činnosti – bilaterální roboticky asistovaná terapie

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