A new mechanical arm trainer to intensify the upper limb rehabilitation of severely affected patients after stroke: design, concept and first case series.
Description and case series on a new mechanical arm trainer with three degrees of freedom (DoF), the REHA-SLIDE (RS), for stroke rehabilitation are presented. Similar to a rolling pin, it consists of two handles at either side of a connecting rod, the handles are bilaterally moved forward and backward, sideways, and rotated, the base plate is inclinable. A computer mouse attached to the rod enables playing games offering computer-biofeedback. Two patients, 6 and 5 weeks after a first-time supratentorial stroke, suffering from a flaccid non-functional upper extremity have been studied. Interventions performed were additional 30 min of RS-training every workday for 6 weeks; one session included 400 repetitions evenly distributed between the forward backward movement and drawing a circle clock- and counter clockwise. Afterwards the patients could play games. Upper extremity portion of the Fugl-Meyer Motor Assessment Score (FM, 0-66), and muscle strength by a Medical Research Council (MRC) sum score (0-45), the FM assessment was blinded. In the 2 patients, the FM (0-66) improved from 7 to 37, and from 17 to 43, their initial (terminal) MRC sum scores were 6 (36) and 13 (31). With the REHA-Slide (RS), severely affected patients practiced a bilateral 3 DoF movement. No conclusions can be drawn so far and a controlled clinical study must be the next step.
Hesse
S
S
Department of Neurological Rehabilitation, Klinik Berlin, Charité University Medicine, Berlin, Germany. bhesse@zedat.fu-berlin.de
Schmidt
H
H
Werner
C
C
Rybski
C
C
Puzich
U
U
Bardeleben
A
A
D000368:Aged; D001132:Arm / Q000503:physiopathology*; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015915:Motion Therapy, Continuous Passive / Q000295:instrumentation*; D053580:Muscle Strength; D010291:Paresis / Q000503:physiopathology / Q000534:rehabilitation*; D020127:Recovery of Function; D012046:Rehabilitation / Q000295:instrumentation*; D020521:Stroke / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome