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.
Department of Veterans Affairs (VA) Maryland Healthcare System, Rehabilitation Research and DevelopmentService, Baltimore, MD, USA. mfinley@som.umaryland.edu
Margaret A
MA
Finley
Susan E
SE
Fasoli
Laura
L
Dipietro
Jill
J
Ohlhoff
Leah
L
Macclellan
Christine
C
Meister
Jill
J
Whitall
Richard
R
Macko
Christopher T
CT
Bever
Hermano I
HI
Krebs
Neville
N
Hogan
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