SaeboResearch
Investigación

El entrenamiento orientado a tareas mejora la función de la extremidad superior en los individuos que sufren lesiones neurológicas. Sin embargo, las opciones de tratamiento son limitadas para clientes neurológicos que no pueden incorporar de manera efectiva la mano con un agarre y suelta funcional / actividades de prensión.

La gran mayoría de supervivientes de un accidente cerebrovascular-ictus, lesión cerebral y los pacientes con lesiones medulares incompletas no tienen suficiente movimiento activo de muñeca y/o extensión de los dedos para permitir que la mano sea funcional. El SaeboFlex tiene la ventaja biomecánica de permitir la ejecución de actividades de prensión / agarre y suelta a personas con moderada – severa hemiparesia.

Runnells K, Anson G, Byblow W. Partial Weight Support of the Arm Affects Corticomotor Selectivity of Biceps Brachii. Journal of NeuroEngineering and Rehabilitation: 12:94, 2015.

Objective: To explore the neurophysiological effect of weight support on the selectivity of biceps brachii activation in healthy adults.

Subjects: 13 participants completed counterbalanced movement tasks in a repeated measures design. Three levels (0, 45, 90% of full support) of weight support were provided to the arm using the SaeboMAS.

Intervention: At each level of weight support, participants maintained a flexed shoulder posture while performing rhythmic isometric elbow flexion or forearm pronation. Single-pulse transcranial magnetic stimulation of the primary cortex was used to elicit motor-evoked potentials (MEP).

Outcome Measures: Baseline muscle activity and MEP amplitude were the primary dependent measures.

Results: With increased support, tonic activity was reduced across all muscles. This effect was greatest in the anti-gravity muscle anterior deltoid, and evident in biceps brachia and pronator teres as well.

Conclusion: Weight support of the arm influences neuromechanical control for the limb. These findings may inform the application of weight support in upper limb stroke rehabilitation.

Pooyania S, Semenko, B. Botulinum toxin type-A (BoNTA) and dynamic wrist-hand orthoses versus orthoses aloe for the treatment of spastic-paretic upper extremity in chronic stroke patients. Open Journal of Therapy and Rehabilitation: 2, 12-18, 2014.

Objective: To explore the neurophysiological effect of weight support on the selectivity of biceps brachii activation in healthy adults.

Subjects: 13 participants completed counterbalanced movement tasks in a repeated measures design. Three levels (0, 45, 90% of full support) of weight support were provided to the arm using the SaeboMAS.

Intervention: At each level of weight support, participants maintained a flexed shoulder posture while performing rhythmic isometric elbow flexion or forearm pronation. Single-pulse transcranial magnetic stimulation of the primary cortex was used to elicit motor-evoked potentials (MEP).

Outcome Measures: Baseline muscle activity and MEP amplitude were the primary dependent measures.

Results: With increased support, tonic activity was reduced across all muscles. This effect was greatest in the anti-gravity muscle anterior deltoid, and evident in biceps brachia and pronator teres as well.

Conclusion: Weight support of the arm influences neuromechanical control for the limb. These findings may inform the application of weight support in upper limb stroke rehabilitation.

Rickards N, Sharma A, Prosser M. Feasibility Audit of SaeboFlex in Stroke Patients: Impact on Recovery Across the Patient Pathway. Journal of the Association of Chartered Physiotherapists in Neurology, 2015, Spring/Summer.

Objective: To audit and assess the feasibility of the introduction and implementation of the use of Saebo throughout the acute to community pathway in Southend-on-sea.

Subjects: 14 acute stroke patients

Intervention: Patients received daily SaeboFlex training for a minimum of 45 minutes per day using repetitive reach and grasp activities appropriate for the patients ability prescribed and reviewed by a Saebo trained therapist.

Outcome Measures: Fugl-Meyer Assessment – Upper Limb portion and video analysis.

Conclusion: The findings of this study suggest that the use of the SaeboFlex can enhance the recovery of the upper limb post stroke.

Jeon H, Woo Y, Yi C, Kwon O, Jung M, Lee Y, Hwang S, Choi B. Effect of Intensive Training With a Spring-Assisted Hand Orthosis on Movement Smoothness in Upper Extremity Following Stroke: A Pilot Clinical Trial. Topics in Stroke Rehabilitation 19(4): 320-328, 2012.

Objective: To assess the feasibility of intensive training using a spring-assisted hand orthosis on upper extremity in individuals with chronic hemiparetic stroke.

Subjects: 10 patients

Intervention: Five patients for the experimental group and five for the control group were recruited from a local rehabilitation hospital. The experimental group participated in four weeks of training using the SaeboFlex orthosis for 1 hour per day, 5 times per week. The control group wore the same orthosis 1 hour per day without participating in upper extremity training.

Outcome Measures: Fugl-Meyer Assessment, Box and Block Test, Action Research Arm Test, and 3D motion analysis system for smoothness of movement.

Conclusion: A pilot clinical study of spring-assisted dynamic hand orthosis training is feasible in recovering the movement of the hemiparetic upper extremity.

Runnells, K, Anson G, Wolf S, Byblow W. Partial Weight Support Differentially Affects Corticomotor Excitability Across Muscles of the Upper Limb. Physiological Reports Vol. 2, Iss. 12, 2014.

Objective: Explore the neurophysiological effects of upper limb weight support in 13 healthy young adults.

Subjects: Thirteen right-handed healthy young adults (six females) without history of upper limb injury or neurological illness. Motor-evoked potentials (MEPs) from transcranial magnetic stimulation (TMS) of primary motor cortex and EMG from anterior deltoid (AD), biceps brachii (BB), extensor carpi radialis (ECR), and first dorsal interosseous (FDI) were assessed.

Intervention: Five levels of weight support, varying from none to full, were provided to the arm using the SaeboMAS. For each level of support, stimulus-response (SR) curves were derived from the MEPs across a range of TMS intensities.

Results: Weight support affected background EMG activity in each of the four muscles examined. Tonic background activity was primarily reduced in the AD. The SR plateau for ECR increased at the lowest support level. For FDI, the SR plateau increased at the highest support level.

Conclusion: The findings indicate that weight support of the proximal upper limb modulates corticomotor excitability across the forearm and hand.

Franck J, Timmermans A, Seelen H. Effects of a Dynamic Hand Orthosis for Functional Use of the Impaired Upper Limb in Sub-Acute Stroke Patients: A Multiple Single Case Experimental Design Study. Technology and Disability 25: 177-187, 2013.

Objective: To investigate the usability and the effects of a dynamic spring-loaded orthosis, adjunct to therapy-as-usual, on functional use of the impaired hand in moderately/severely impaired sub-acute stroke patients.

Subjects: 8 patients

Intervention: The SaeboFlex was used for six weeks, five days/week, 45 min./day, and adjunct to therapy-as-usual.

Outcome Measures: Action Research Arm Test, ABILHAND, Intrinsic Motivation Inventory.

Conclusion: Patients in the early sub-acute phase of stroke that display little to modest improvement on their capacity to perform activities or their perceived level of daily performance, benefit most from the SaeboFlex training.