TY - JOUR
T1 - Robot-assisted rehabilitation of ankle plantar flexors spasticity
T2 - A 3month study with proprioceptive neuromuscular facilitation
AU - Zhou, Zhihao
AU - Sun, Yao
AU - Wang, Ninghua
AU - Gao, Fan
AU - Wei, Kunlin
AU - Wang, Qining
N1 - Publisher Copyright:
© 2016 Zhou, Sun, Wang, Gao, Wei and Wang.
PY - 2016
Y1 - 2016
N2 - 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 robotassisted system was proposed, and seven poststroke patients with hemiplegic spastic ankles participated in a 3month 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 2min passive stretching to warmingup 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°, 10°, and 20°) decreased (p < 0.05, p < 0.001, and p < 0.001, respectively), and quasistatic stiffness under different dorsiflexion angle levels (0°, 10°, and 20°) also decreased (p < 0.01, p < 0.001, and p < 0.001, respectively). Achilless 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 UpandGo (p < 0.05), normal walking speed (p > 0.05), and fast walking speed (p < 0.05). These results indicated that the PNF-based 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.
AB - 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 robotassisted system was proposed, and seven poststroke patients with hemiplegic spastic ankles participated in a 3month 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 2min passive stretching to warmingup 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°, 10°, and 20°) decreased (p < 0.05, p < 0.001, and p < 0.001, respectively), and quasistatic stiffness under different dorsiflexion angle levels (0°, 10°, and 20°) also decreased (p < 0.01, p < 0.001, and p < 0.001, respectively). Achilless 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 UpandGo (p < 0.05), normal walking speed (p > 0.05), and fast walking speed (p < 0.05). These results indicated that the PNF-based 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.
KW - Ankle spasticity
KW - Plantar flexors
KW - Proprioceptive neuromuscular facilitation
KW - Robotassisted
UR - http://www.scopus.com/inward/record.url?scp=85015713165&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85015713165&partnerID=8YFLogxK
U2 - 10.3389/fnbot.2016.00016
DO - 10.3389/fnbot.2016.00016
M3 - Article
C2 - 27895574
AN - SCOPUS:85015713165
SN - 1662-5218
VL - 10
JO - Frontiers in Neurorobotics
JF - Frontiers in Neurorobotics
IS - NOV
M1 - 16
ER -