目的:机器人手臂是ALS患者手臂和手进行性运动缺陷的创新辅助设备。目的是探索患者对机械臂系统的期望,并评估提供设备后的实际经验。
方法:在德国9个ALS中心进行了一项前瞻性观察性研究。使用修订的ALS功能评定量表(ALSFRS-R)评估ALS相关的功能缺陷。使用ALSFRS-R的三个手臂相关项目的子得分确定上肢的运动缺陷(项目4-6;范围0-12分)。提供前的用户期望(期望组,n=85)和配置后的用户体验(体验组,n=14)与装置(JACO辅助机器人装置,Kinova,Boisbriand,QC,加拿大)进行了评估。
结果:在总队列中,手臂功能的ALSFRS-R分均值为1.7(SD:2.0,0-9),显示上肢严重的功能缺陷.在期望组(n=85)中,机械臂的以下用例已被优先考虑:处理对象(89%),近距离运动(88%),按下按钮(87%),提供饮料(86%),打开橱柜和门(85%)。在经验组(n=14)中,处理对象(79%),提供饮料(79%),近身运动(71%),按下按钮(71%),供应食物(64%),开门(64%)是最常见的案例。大多数患者每天使用该设备(71.4%,n=10),28.6%(n=4)每周几次。体验组的所有患者都发现该设备很有帮助,在使用该设备时感到安全,并对其可靠性感到满意。辅助机械臂的NPS显示64%的“推动者”(强烈推荐),29%的“冷漠”(不确定的建议)和7%的“批评者”(无建议)。总NPS为+57,表明患者满意度较强。
结论:开始使用机器人辅助臂进行采购仅限于患有严重上肢功能缺陷的患者。用户体验强调了ALS中辅助机械臂的广泛用例。积极的用户体验和高满意度强调了机械臂系统作为ALS患者手臂严重运动缺陷的有价值的治疗选择。
OBJECTIVE: Robotic arms are innovative assistive devices for ALS patients with progressive motor deficits of arms and hands. The objective was to explore the patients´ expectations towards a robotic arm system and to assess the actual experiences after the provision of the device.
METHODS: A prospective observational study was conducted at 9 ALS centers in Germany. ALS-related functional deficits were assessed using the ALS-Functional Rating Scale-revised (ALSFRS-R). Motor deficit of the upper limbs was determined using a subscore of three arm-related items of the ALSFRS-R (items 4-6; range 0-12 points). User expectations before provision (expectation group, n = 85) and user experiences after provision (experience group, n = 14) with the device (JACO Assistive Robotic Device, Kinova, Boisbriand, QC, Canada) were assessed.
RESULTS: In the total cohort, mean ALSFRS-R subscore for arm function was 1.7 (SD: 2.0, 0-9) demonstrating a severe functional deficit of the upper limbs. In the expectation group (n = 85), the following use cases of the robotic arm have been prioritized: handling objects (89%), close-body movements (88%), pressing buttons (87%), serving drinks (86%), and opening cabinets and doors (85%). In the experience group (n = 14), handling objects (79%), serving drinks (79%), near-body movements (71%), pushing buttons (71%), serving food (64%), and opening doors (64%) were the most frequent used cases. Most patients used the device daily (71.4%, n = 10), and 28.6% (n = 4) several times a week. All patients of the experience group found the device helpful, felt safe while using the device, and were satisfied with its reliability. NPS of the assistive robotic arm revealed 64% \"promoters\" (strong recommendation), 29% \"indifferents\" (uncertain recommendation) and 7% \"detractors\" (no recommendation). Total NPS was + 57 demonstrating strong patient satisfaction.
CONCLUSIONS: Initiation of procurement with a robotic assistive arm was confined to patients with severe functional deficit of the upper limbs. User experience underlined the wide spectrum of use cases of assistive robotic arms in ALS. The positive user experience together with high satisfaction underscore that robotic arm systems serve as a valuable treatment option in ALS patients with severe motor deficits of the arms.