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This study aims to compare the effectiveness of Robot-Assisted Tai Chi Training (RATT) versus conventional rehabilitation in improving upper limb motor function post-stroke, and to explore the neuromuscular mechanisms of RATT. Participants will be randomly assigned to one of two groups:
Both groups will receive 60-minute sessions, administered 5 days a week, over 4 weeks. Researchers will measure improvements using clinical scales (e.g., Fugl-Meyer Assessment) and monitor safety.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Tai Chi-based rehabilitation robot group | Experimental |
| |
| Conventional rehabilitation group | Experimental |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Robot-Assisted Tai Chi Training | Device | This intervention involves robot-assisted Tai Chi training for upper limb rehabilitation, delivered in a seated position to ensure participant safety and comfort. Each 60-minute session consists of a 5-minute warm-up/preparation phase, followed by three 15-minute segmented functional training phases incorporating Tai Chi-inspired movements to target upper limb coordination, range of motion, and strength recovery, interspersed with two 5-minute rest intervals. The protocol is administered 5 times per week over 4 weeks, with robotic assistance tailored to guide functional upper limb trajectories while minimizing compensatory movements. |
| Measure | Description | Time Frame |
|---|---|---|
| Fugl-Meyer Upper Extremity Scale | Score range 0-66, higher scores indicate better upper limb motor recovery. | 4 weeks (post-intervention) |
| Measure | Description | Time Frame |
|---|---|---|
| Wolf Motor Function Test | The Wolf Motor Function Test (WMFT) evaluates upper limb motor function in conditions like stroke through 15 timed functional tasks (e.g., lifting objects) and 2 strength tasks. It scores Performance Time (total seconds; lower = faster) and Functional Ability (0-5 per task, max 75; higher = better movement quality), with improved motor recovery indicated by reduced time and increased ability scores. |
| Measure | Description | Time Frame |
|---|---|---|
| Upper Limb Muscle Synergy Patterns | Surface electromyography (sEMG) signals were collected from upper limb muscles during drinking and forward-reaching tasks. Muscle synergy patterns underlying these functional movements were extracted and analyzed using non-negative matrix factorization (NMF). | 4 weeks |
| Kinematic Analysis of Upper Limb Movements During Functional Motor Tasks |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Jingsong Wu | Contact | 13609501214 | jingsongwu01@163.com |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Rehabilitation Hospital Affiliated to Fujian University of Traditional Chinese Medicine | Recruiting | Fuzhou | Fujian | 350003 | China |
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| ID | Term |
|---|---|
| D020521 | Stroke |
| ID | Term |
|---|---|
| D002561 | Cerebrovascular Disorders |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
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| Conventional rehabilitation training | Behavioral | This intervention follows evidence-based clinical guidelines for post-stroke upper limb rehabilitation, focusing on therapist-guided task-oriented training that integrates activities of daily living (ADL) such as table wiping and clothes hanging. Sessions emphasize progressive functional integration, with exercises adjusted weekly based on patient performance. Training is delivered in 60-minute sessions (1 session/day), 5 days per week over 4 weeks, under direct therapist supervision to ensure proper movement patterns and safety. |
|
| 4 weeks |
| Shoulder Range of Motion | Shoulder active (AROM) and passive (PROM) range of motion were assessed in flexion, abduction, and rotation using a standardized protocol. | 4 weeks |
| Upper Limb Muscle Strength Assessment | Muscle strength is assessed using Manual Muscle Testing (MMT) graded via the Medical Research Council (MRC) Scale (range: 0-5, where 0 = no muscle contraction and 5 = normal strength, higher scores indicate better outcomes). | 4 weeks |
| Trunk Impairment Scale | The 17-item Trunk Impairment Scale (TIS) comprises three subscales: static sitting balance (3 items), dynamic sitting balance (10 items), and coordination (4 items). Each item is scored on a 2-, 3- or 4-point ordinal scale from 0 to 3, with the maximal scores for the static and dynamic sitting balance and coordination subscales that can be attained being 7, 10 and 6. The total scores for the TIS range from 0 to 23, representing the lowest to the highest level of body balancing function. | 4 weeks |
| Modified Barthel Index | Score range 0-100, higher scores indicate better independence in activities of daily living. | 4 weeks |
| Stroke-Specific Quality of Life Scale | Score range 49-245, higher scores indicate better health-related quality of life in stroke survivors. | 4 weeks |
Upper limb kinematic data (movement trajectories and joint angles) were acquired via the OpenCap system during drinking and forward-reaching tasks. Joint moments were subsequently estimated using inverse dynamics, and task-specific motor patterns were extracted to quantify kinematic synergies and torque profiles. |
| 4 weeks |
| Multimodal Neuroimaging Analysis | Structural (T1-MPRAGE) and resting-state fMRI data were acquired using a 3T MRI scanner. Structural analysis assessed gray matter volume and density, cortical thickness, and surface area, while functional analysis evaluated amplitude of low-frequency fluctuations (ALFF), regional homogeneity (ReHo), functional connectivity (FC), and graph theory-based network topology metrics (global/local efficiency). | 4 weeks |
| The Third People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine | Recruiting | Fuzhou | Fujian | 350122 | China |
|
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |