title: Robotic therapy provides a stimulus for upper limb motor recovery after stroke that is complementary to and distinct from conventional therapy.
abstract: BACKGROUND
  Individuals with chronic stroke often have long-lasting upper extremity impairments that impede function during activities of daily living. Rehabilitation robotics have shown promise in improving arm function, but current systems do not allow realistic training of activities of daily living. We have incorporated the ARMin III and HandSOME device into a novel robotic therapy modality that provides functional training of reach and grasp tasks.
  
  
  OBJECTIVE
  To compare the effects of equal doses of robotic and conventional therapy in individuals with chronic stroke.
  
  
  METHODS
  Subjects were randomized to 12 hours of robotic or conventional therapy and then crossed over to the other therapy type after a 1-month washout period. Twelve moderate to severely impaired individuals with chronic stroke were enrolled, and 10 completed the study.
  
  
  RESULTS
  Across the 3-month study period, subjects showed significant improvements in the Fugl-Meyer (P = .013) and Box and Blocks tests (P = .028). The robotic intervention produced significantly greater improvements in the Action Research Arm Test than conventional therapy (P = .033). Gains in the Box and Blocks test from conventional therapy were larger than from robotic therapy in subjects who received conventional therapy after robotic therapy (P = .044).
  
  
  CONCLUSIONS
  Data suggest that robotic therapy can elicit improvements in arm function that are distinct from conventional therapy and supplements conventional methods to improve outcomes. Results from this pilot study should be confirmed in a larger study.
authors.affiliation: 1MedStar National Rehabilitation Hospital, Washington, DC, USA.
authors.forename: Elizabeth B
authors.initials: EB
authors.lastname: Brokaw
authors.forename: Diane
authors.initials: D
authors.lastname: Nichols
authors.forename: Rahsaan J
authors.initials: RJ
authors.lastname: Holley
authors.forename: Peter S
authors.initials: PS
authors.lastname: Lum
mesh_terms: D002908:Chronic Disease; D018592:Cross-Over Studies; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D012371:Robotics / Q000379:methods*; D012720:Severity of Illness Index; D020521:Stroke / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D013997:Time Factors; D016896:Treatment Outcome; D034941:Upper Extremity; D014584:User-Computer Interface
keywords: arm; function; motor; robotics; stroke; therapy