title: Intensive sensorimotor arm training mediated by therapist or robot improves hemiparesis in patients with chronic stroke.
abstract: Investigators have demonstrated that a variety of intensive movement training protocols for persistent upper limb paralysis in patients with chronic stroke (6 months or more after stroke) improve motor outcome. This randomized controlled study determined in patients with upper limb motor impairment after chronic stroke whether movement therapy delivered by a robot or by a therapist using an intensive training protocol was superior. Robotic training (n = 11) and an intensive movement protocol (n = 10) improved the impairment measures of motor outcome significantly and comparably; there were no significant changes in disability measures. Motor gains were maintained at the 3-month evaluation after training. These data contribute to the growing awareness that persistent impairments in those with chronic stroke may not reflect exhausted capacity for improvement. These new protocols, rendered by either therapist or robot, can be standardized, tested, and replicated, and potentially will contribute to rational activity-based programs.
authors.affiliation: Department of Neurology and Neuroscience, Burke Institute of Medical Research, Weill Medical College, Cornell University, White Plains, NY, USA. btv3@cornell.edu
authors.forename: Bruce T
authors.initials: BT
authors.lastname: Volpe
authors.forename: Daniel
authors.initials: D
authors.lastname: Lynch
authors.forename: Avrielle
authors.initials: A
authors.lastname: Rykman-Berland
authors.forename: Mark
authors.initials: M
authors.lastname: Ferraro
authors.forename: Michael
authors.initials: M
authors.lastname: Galgano
authors.forename: Neville
authors.initials: N
authors.lastname: Hogan
authors.forename: Hermano I
authors.initials: HI
authors.lastname: Krebs
mesh_terms: D001132:Arm / Q000294:innervation / Q000503:physiopathology*; D002908:Chronic Disease; D005081:Exercise Therapy / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010291:Paresis / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D026741:Physical Therapy Modalities / Q000295:instrumentation*; D019736:Prostheses and Implants; D020127:Recovery of Function / Q000502:physiology; D012371:Robotics / Q000295:instrumentation / Q000379:methods*; D020521:Stroke / Q000150:complications / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D013663:Teaching / Q000379:methods; D016896:Treatment Outcome