title: A comparison of functional and impairment-based robotic training in severe to moderate chronic stroke: a pilot study.
abstract: OBJECTIVE
  To compare the outcome of training the functional movement of transport of the arm and grasping an object with the alternative of training the transport of the arm in isolation.
  
  
  METHODS
  Pretest-posttest comparison.
  
  
  METHODS
  Rehabilitation hospitals, outpatient care.
  
  
  METHODS
  Volunteer sample of forty-seven persons with persistent hemiparesis from a single, unilateral stroke within the past one to five years.
  
  
  METHODS
  Robotic therapy 3 x/week for 6 weeks for the paretic upper limb consisted of either a) sensorimotor, active-assistive impairment-based exercise during repetitive planar reaching tasks, or b) a "free-hand" approach, in which the robot assisted subjects employing the sensorimotor active-assistive exercise to transport the hand to a series of targets, where it stopped to allow the person to interact with actual objects (functional approach 1), or c) transport and manipulation, in which the robot assisted subjects employing active-assistive exercise during repetitive planar reaching tasks while grasping a simulated object and releasing it at the target or followed by grasp and release of a simulated object (functional approach 2).
  
  
  METHODS
  Fugl-Meyer Assessment.
  
  
  RESULTS
  All three groups improved from pre- to post-treatment with the sensorimotor impairment based approach demonstrating the best outcome of the three approaches.
  
  
  CONCLUSIONS
  Short-term, goal-directed robotic therapy can significantly improve motor abilities of the exercised limb segments in persons with chronic stroke, but contrary to expectation, training both the transport of the arm and manipulation of an object (functionally-based approaches) did not confer any advantage over training solely transport of the arm (impairment-based approach).
authors: Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139, USA. hikrebs@mit.edu
authors: Hermano Igo
authors: HI
authors: Krebs
authors: Stephen
authors: S
authors: Mernoff
authors: Susan E
authors: SE
authors: Fasoli
authors: Richard
authors: R
authors: Hughes
authors: Joel
authors: J
authors: Stein
authors: Neville
authors: N
authors: Hogan
mesh_terms: D000328:Adult; D000368:Aged; D001132:Arm; D002908:Chronic Disease; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D018737:Hand Strength; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology; D010291:Paresis / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D020127:Recovery of Function / Q000502:physiology; D012371:Robotics; D020521:Stroke / Q000150:complications / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome