title: Hand function recovery in chronic stroke with HEXORR robotic training: A case series.
abstract: After a stroke, many survivors have impaired motor function. Robotic rehabilitation techniques have emerged to provide a repetitive, activity-based therapy at potentially lower cost than conventional methods. Many patients exhibit intrinsic resistance to hand extension in the form of spasticity and/or hypertonia. We have developed a therapy program using the Hand Exoskeleton Rehabilitation Robot (HEXORR) that is capable of compensating for tone to assist patients in opening the paretic hand. The system can move the user's hand, assist movement, allow free movement, or restrict movement to allow static force production. These options combine with an interactive virtual reality game to enhance user motivation. Four chronic stroke subjects received 18 sessions of robot therapy as well as pre and post evaluation sessions. All subjects showed at least modest gains in active finger range of motion (ROM) measured in the robot, and all but one subject had gains in active thumb ROM. Most of these gains carried over to ROM gains outside of the robot. The clinical measures (Fugl-Meyer, Box-and-Blocks) showed clear improvements in two subjects and mixed results in two subjects. Overall, the robot therapy was well received by subjects and shows promising results. We conclude HEXORR therapy is best suited for patients with mild-moderate tone and at least minimal extension.
authors.affiliation: Catholic University of America, Washington, DC 20064 USA. 90godfrey@cardinalmail.cua.edu
authors.forename: Sasha Blue
authors.initials: SB
authors.lastname: Godfrey
authors.forename: Christopher N
authors.initials: CN
authors.lastname: Schabowsky
authors.forename: Rahsaan J
authors.initials: RJ
authors.lastname: Holley
authors.forename: Peter S
authors.initials: PS
authors.lastname: Lum
mesh_terms: D000328:Adult; D002908:Chronic Disease; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005260:Female; D006225:Hand; D006801:Humans; D008297:Male; D008875:Middle Aged; D009069:Movement Disorders / Q000209:etiology / Q000534:rehabilitation*; D026741:Physical Therapy Modalities / Q000295:instrumentation*; D020127:Recovery of Function; D012371:Robotics / Q000295:instrumentation*; D020521:Stroke / Q000150:complications; D000071939:Stroke Rehabilitation; D013813:Therapy, Computer-Assisted / Q000295:instrumentation*; D016896:Treatment Outcome