| Title | Robot-Assisted Rehabilitation of Ankle Plantar Flexors spasticity: A 3-Month Study with Proprioceptive Neuromuscular Facilitation |
| Authors | Zhou, Zhihao Sun, Yao Wang, Ninghua Gao, Fan Wei, Kunlin Wang, Qining |
| Affiliation | Peking Univ, Coll Engn, Robot Res Grp, Beijing, Peoples R China. Peking Univ, Beijing Innovat Ctr Engn Sci & Adv Technol BIC ES, Beijing, Peoples R China. Univ Victoria, Rehabil Neurosci Lab, Victoria, BC, Canada. Peking Univ, Hosp 1, Dept Rehabil Med, Beijing, Peoples R China. Univ Texas Southwestern Med Ctr Dallas, Dept Hlth Care Sci, Dallas, TX 75390 USA. Peking Univ, Dept Psychol, Motor Control Lab, Beijing, Peoples R China. Peking Univ, Coll Engn, Robot Res Grp, Beijing, Peoples R China. Wang, QN (reprint author), Peking Univ, Beijing Innovat Ctr Engn Sci & Adv Technol BIC ES, Beijing, Peoples R China. |
| Keywords | ankle spasticity plantar flexors proprioceptive neuromuscular facilitation robot-assisted rehabilitation stroke STRETCH REFLEX FOOT ORTHOSIS MUSCLE STROKE GAIT CONTRACTURE HEMIPLEGIA WALKING DESIGN IMPACT |
| Issue Date | 2016 |
| Publisher | FRONTIERS IN NEUROROBOTICS |
| Citation | FRONTIERS IN NEUROROBOTICS.2016,10. |
| Abstract | In this paper, we aim to investigate the effect of proprioceptive neuromuscular facilitation (PNF)-based rehabilitation for ankle plantar flexors spasticity by using a Robotic Ankle-foot Rehabilitation System (RARS). A modified robot-assisted system was proposed, and seven poststroke patients with hemiplegic spastic ankles participated in a 3-month robotic PNF training. Their impaired sides were used as the experimental group, while their unimpaired sides as the control group. A robotic intervention for the experimental group started from a 2-min passive stretching to warming-up or relaxing the soleus and gastrocnemius muscles and also ended with the same one. Then a PNF training session including 30 trials was activated between them. The rehabilitation trainings were carried out three times a week as an addition to their regular rehabilitation exercise. Passive range of motion, resistance torque, and stiffness were measured in both ankles before and after the interventions. The changes in Achilles tendon length, walking speed, and lower limb function were also evaluated by the same physician or physiotherapist for each participant. Biomechanical measurements before interventions showed significant difference between the experimental group and the control group due to ankle spasticity. For the control group, there was no significant difference in the 3 months with no robotic intervention. But for the experimental group, passive dorsiflexion range of motion increased (p < 0.01), resistance torque under different dorsiflexion angle levels (0 degrees, 10 degrees, and 20 degrees) decreased (p < 0.05, p < 0.001, and p < 0.001, respectively), and quasi-static stiffness under different dorsiflexion angle levels (0 degrees, 10 degrees, and 20 degrees) also decreased (p < 0.01, p < 0.001, and p < 0.001, respectively). Achilles's tendon length shortened (p < 0.01), while its thickness showed no significant change (p > 0.05). The robotic rehabilitation also improved the muscle strength (p < 0.01) and muscle control performance (p < 0.001). In addition, improvements were observed in clinical and functional measurements, such as Timed Up-and-Go (p < 0.05), normal walking speed (p > 0.05), and fast walking speed (p < 0.05). These results indicated that the PNFbased robotic intervention could significantly alleviate lower limb spasticity and improve the motor function in chronic stroke participant. The robotic system could potentially be used as an effective tool in poststroke rehabilitation training. |
| URI | http://hdl.handle.net/20.500.11897/458449 |
| ISSN | 1662-5218 |
| DOI | 10.3389/fnbot.2016.00016 |
| Indexed | SCI(E) |
| Appears in Collections: | 工学院 第一医院 心理与认知科学学院 |
