Robot-assisted movement training compared with conventional therapy techniques for the rehabilitation of upper-limb motor function after stroke.
OBJECTIVE
To compare the effects of robot-assisted movement training with conventional techniques for the rehabilitation of upper-limb motor function after stroke.


METHODS
Randomized controlled trial, 6-month follow-up.


METHODS
A Department of Veterans Affairs rehabilitation research and development center.


METHODS
Consecutive sample of 27 subjects with chronic hemiparesis (>6mo after cerebrovascular accident) randomly allocated to group.


METHODS
All subjects received twenty-four 1-hour sessions over 2 months. Subjects in the robot group practiced shoulder and elbow movements while assisted by a robot manipulator. Subjects in the control group received neurodevelopmental therapy (targeting proximal upper limb function) and 5 minutes of exposure to the robot in each session.


METHODS
Fugl-Meyer assessment of motor impairment, FIMtrade mark instrument, and biomechanic measures of strength and reaching kinematics. Clinical evaluations were performed by a therapist blinded to group assignments.


RESULTS
Compared with the control group, the robot group had larger improvements in the proximal movement portion of the Fugl-Meyer test after 1 month of treatment (P<.05) and also after 2 months of treatment (P<.05). The robot group had larger gains in strength (P<.02) and larger increases in reach extent (P<.01) after 2 months of treatment. At the 6-month follow-up, the groups no longer differed in terms of the Fugl-Meyer test (P>.30); however, the robot group had larger improvements in the FIM (P<.04).


CONCLUSIONS
Compared with conventional treatment, robot-assisted movements had advantages in terms of clinical and biomechanical measures. Further research into the use of robotic manipulation for motor rehabilitation is justified.
Lum
Peter S
PS
Rehabilitation Research & Development Center, VA Palo Alto Health Care System, Palo Alto, CA, USA.
Burgar
Charles G
CG
Shor
Peggy C
PC
Majmundar
Matra
M
Van der Loos
Machiel
M
D000368:Aged; D000704:Analysis of Variance; D001132:Arm / Q000502:physiology / Q000503:physiopathology*; D001696:Biomechanical Phenomena; D002908:Chronic Disease; D005246:Feedback; D005500:Follow-Up Studies; D006801:Humans; D015915:Motion Therapy, Continuous Passive / Q000295:instrumentation*; D009119:Muscle Contraction; D010291:Paresis / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D016059:Range of Motion, Articular; D012371:Robotics; D018401:Sample Size; D013314:Stress, Mechanical; D020521:Stroke / Q000150:complications / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome