Short-duration robotic therapy in stroke patients with severe upper-limb motor impairment.
Chronic motor deficits in the upper limb (UL) are a major contributor to disability following stroke. This study investigated the effect of short-duration robot-assisted therapy on motor impairment, as measured by clinical scales and robot-derived performance measures in patients with chronic, severe UL impairments after stroke. As part of a larger study, 15 individuals with chronic, severe UL paresis (Fugl-Meyer < 15) after stroke (minimum 6 mo postonset) performed 18 sessions of robot-assisted UL rehabilitation that consisted of goal-directed planar reaching tasks over a period of 3 weeks. Outcome measures included the Fugl-Meyer Assessment, the Motor Power Assessment, the Wolf Motor Function Test, the Stroke Impact Scale, and five robot-derived measures that reflect motor control (aiming error, mean speed, peak speed, mean:peak speed ratio, and movement duration). Robot-assisted training produced statistically significant improvements from baseline to posttreatment in the Fugl-Meyer and Motor Power Assessment scores and the quality of motion (quantified by a reduction in aiming error and movement duration with an increase in mean speed and mean:peak speed ratio). Our findings indicate that robot-assisted UL rehabilitation can reduce UL impairment and improve motor control in patients with severe UL paresis from chronic stroke.
Finley
Margaret A
MA
Department of Veterans Affairs (VA) Maryland Healthcare System, Rehabilitation Research and DevelopmentService, Baltimore, MD, USA. mfinley@som.umaryland.edu
Fasoli
Susan E
SE
Dipietro
Laura
L
Ohlhoff
Jill
J
Macclellan
Leah
L
Meister
Christine
C
Whitall
Jill
J
Macko
Richard
R
Bever
Christopher T
CT
Krebs
Hermano I
HI
Hogan
Neville
N
D000704:Analysis of Variance; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010291:Paresis / Q000209:etiology / Q000534:rehabilitation*; D026741:Physical Therapy Modalities / Q000295:instrumentation*; D011336:Probability; D011446:Prospective Studies; D011597:Psychomotor Performance; D020127:Recovery of Function; D012371:Robotics; D012720:Severity of Illness Index; D020521:Stroke / Q000150:complications* / Q000175:diagnosis; D013997:Time Factors; D016896:Treatment Outcome; D034941:Upper Extremity