Effects of arm training with the robotic device ARMin I in chronic stroke: three single cases.
BACKGROUND
Several clinical studies on chronic stroke conducted with end-effector-based robots showed improvement of the motor function in the affected arm. Compared to end-effector-based robots, exoskeleton robots provide improved guidance of the human limb and are better suited to train task-oriented movements with a large range of motions.


OBJECTIVE
To test whether intensive arm training with the arm exoskeleton ARMin I is feasible with chronic-stroke patients and whether it improves motor function in the paretic arm.


METHODS
Three single cases with chronic hemiparesis resulting from unilateral stroke (at least 14 months after stroke). A-B design with 2 weeks of multiple baseline measurements (A), 8 weeks of training (B) with repetitive measurements and a follow-up measurement 8 weeks after training. The training included shoulder and elbow movements with the robotic rehabilitation device ARMin I. Two subjects had three 1-hour sessions per week and 1 subject received five 1-hour sessions per week. The main outcome measurement was the upper-limb part of the Fugl-Meyer Assessment (FMA).


RESULTS
The ARMin training was well tolerated by the patients, and the FMA showed moderate, but significant improvements for all 3 subjects (p < 0.05). Most improvements were maintained 8 weeks after discharge.


CONCLUSIONS
This study indicates that intensive training with an arm exoskeleton is feasible with chronic-stroke patients. Moderate improvements were found in all 3 subjects, thus further clinical investigations are justified.
Nef
Tobias
T
Department of Biomedical Engineering, Catholic University of America, Washington, DC 20064, USA. nef@cua.edu
Quinter
Gabriela
G
Müller
Roland
R
Riener
Robert
R
D000368:Aged; D001132:Arm / Q000503:physiopathology*; D002908:Chronic Disease; D004185:Disability Evaluation; D005081:Exercise Therapy / Q000295:instrumentation* / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D007839:Functional Laterality / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D012371:Robotics; D020521:Stroke / Q000503:physiopathology*; D000071939:Stroke Rehabilitation