title: Robot-assisted upper-limb therapy in acute rehabilitation setting following stroke: Department of Veterans Affairs multisite clinical trial.
abstract: This randomized, controlled, multisite Department of Veterans Affairs clinical trial assessed robot-assisted (RA) upper-limb therapy with the Mirror Image Movement Enabler (MIME) in the acute stroke rehabilitation setting. Hemiparetic subjects (n = 54) received RA therapy using MIME for either up to 15 hours (low-dose) or 30 hours (high-dose) or received up to 15 hours of additional conventional therapy in addition to usual care (control). The primary outcome measure was the Fugl-Meyer Assessment (FMA). The secondary outcome measures were the Functional Independence Measure (FIM), Wolf Motor Function Test, Motor Power, and Ashworth scores at intake, discharge, and 6-month follow-up. Mean duration of study treatment was 8.6, 15.8, and 9.4 hours for the low-dose, high-dose, and control groups, respectively. Gains in the primary outcome measure were not significantly different between groups at follow-up. Significant correlations were found at discharge between FMA gains and the dose and intensity of RA. Intensity also correlated with FMA gain at 6 months. The high-dose group had greater FIM gains than controls at discharge and greater tone but no difference in FIM changes compared with low-dose subjects at 6 months. As used during acute rehabilitation, motor-control changes at follow-up were no less with MIME than with additional conventional therapy. Intensity of training with MIME was positively correlated with motor-control gains.
authors.affiliation: Central Texas Veterans Health Care System, Functional Restoration (007), 1901 Veterans Memorial Drive, Temple, TX 76504, USA. Charles.Burgar1@va.gov
authors.forename: Charles G
authors.initials: CG
authors.lastname: Burgar
authors.forename: Peter S
authors.initials: PS
authors.lastname: Lum
authors.forename: A M Erika
authors.initials: AM
authors.lastname: Scremin
authors.forename: Susan L
authors.initials: SL
authors.lastname: Garber
authors.forename: H F Machiel
authors.initials: HF
authors.lastname: Van der Loos
authors.forename: Deborah
authors.initials: D
authors.lastname: Kenney
authors.forename: Peggy
authors.initials: P
authors.lastname: Shor
mesh_terms: D000368:Aged; D006787:Hospitals, Veterans; D006801:Humans; D008875:Middle Aged; D010291:Paresis / Q000209:etiology / Q000534:rehabilitation*; D011597:Psychomotor Performance; D020127:Recovery of Function; D012371:Robotics; D000071939:Stroke Rehabilitation; D034941:Upper Extremity