A novel approach to stroke rehabilitation: robot-aided sensorimotor stimulation.
OBJECTIVE
In patients with stroke, the authors tested whether additional sensorimotor training of the paralyzed or paretic upper limb delivered by a robotic device enhanced motor outcome.


METHODS
Fifty-six patients with stroke and hemiparesis or hemiplegia received standard poststroke multidisciplinary rehabilitation, and were randomly assigned either to receive robotic training (at least 25 hours) or exposure to the robotic device without training. Outcomes were assessed by the same masked raters, before treatment began and at the end of treatment, with the upper extremity component of the Fugl-Meyer Motor Assessment, the Motor Status score, the Motor Power score, and Functional Independence Measurement.


RESULTS
The robot treatment and control group had comparable clinical characteristics, lesion size, and pretreatment impairment scores. By the end of treatment, the robot-trained group demonstrated improvement in motor outcome for the trained shoulder and elbow (Motor Power score, p < 0.001; Motor Status score, p < 0. 01) that did not generalize to untrained wrist and hand. The robot-treated group also demonstrated significantly improved functional outcome (Functional Independence Measurement-Motor, p < 0. 01).


CONCLUSIONS
Robot-delivered quantitative and reproducible sensorimotor training enhanced the motor performance of the exercised shoulder and elbow. The robot-treated group also demonstrated improved functional outcome. When added to standard multidisciplinary rehabilitation, robotics provides novel therapeutic strategies that focus on impairment reduction and improved motor performance.
Volpe
B T
BT
Department of Neurology and Neuroscience, Cornell University Medical College, Burke Institute of Medical Research, White Plains, NY 10605, USA. volpe@rockvax.rockefeller.edu
Krebs
H I
HI
Hogan
N
N
Edelstein OTR
L
L
Diels
C
C
Aisen
M
M
D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D005260:Female; D006429:Hemiplegia / Q000209:etiology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009048:Motor Skills / Q000502:physiology; D009788:Occupational Therapy; D010348:Patient Care Team; D012371:Robotics; D012682:Sensory Aids; D020521:Stroke / Q000209:etiology; D000071939:Stroke Rehabilitation; D013813:Therapy, Computer-Assisted / Q000295:instrumentation*