Accelerometry measuring the outcome of robot-supported upper limb training in chronic stroke: a randomized controlled trial.
OBJECTIVE
This study aims to assess the extent to which accelerometers can be used to determine the effect of robot-supported task-oriented arm-hand training, relative to task-oriented arm-hand training alone, on the actual amount of arm-hand use of chronic stroke patients in their home situation.


METHODS
This single-blind randomized controlled trial included 16 chronic stroke patients, randomly allocated using blocked randomization (n = 2) to receive task-oriented robot-supported arm-hand training or task-oriented (unsupported) arm-hand training. Training lasted 8 weeks, 4 times/week, 2 × 30 min/day using the (T-)TOAT ((Technology-supported)-Task-Oriented-Arm-Training) method. The actual amount of arm-hand use, was assessed at baseline, after 8 weeks training and 6 months after training cessation. Duration of use and intensity of use of the affected arm-hand during unimanual and bimanual activities were calculated.


RESULTS
Duration and intensity of use of the affected arm-hand did not change significantly during and after training, with or without robot-support (i.e. duration of use of unimanual use of the affected arm-hand: median difference of -0.17% in the robot-group and -0.08% in the control group between baseline and after training cessation; intensity of the affected arm-hand: median difference of 3.95% in the robot-group and 3.32% in the control group between baseline and after training cessation). No significant between-group differences were found.


CONCLUSIONS
Accelerometer data did not show significant changes in actual amount of arm-hand use after task-oriented training, with or without robot-support. Next to the amount of use, discrimination between activities performed and information about quality of use of the affected arm-hand are essential to determine actual arm-hand performance.


BACKGROUND
Controlled-trials.com ISRCTN82787126.
Research School CAPHRI, Department of Rehabilitation Medicine, Maastricht University, Maastricht, the Netherlands; Adelante, Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, the Netherlands.
Ryanne J M
RJ
Lemmens
Research School CAPHRI, Department of Rehabilitation Medicine, Maastricht University, Maastricht, the Netherlands; Adelante, Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, the Netherlands; BIOMED Biomedical Research Institute, Hasselt University, Diepenbeek, Belgium.
Annick A A
AA
Timmermans
Research School CAPHRI, Department of Rehabilitation Medicine, Maastricht University, Maastricht, the Netherlands; Adelante, Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, the Netherlands.
Yvonne J M
YJ
Janssen-Potten
Adelante, Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, the Netherlands.
Sanne A N T D
SA
Pulles
Adelante, Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, the Netherlands.
Richard P J
RP
Geers
Adelante, Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, the Netherlands; Adelante Rehabilitation Centre, Hoensbroek, the Netherlands.
Wilbert G M
WG
Bakx
Research School CAPHRI, Department of Rehabilitation Medicine, Maastricht University, Maastricht, the Netherlands; Adelante, Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, the Netherlands; Department of Rehabilitation Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands.
Rob J E M
RJ
Smeets
Research School CAPHRI, Department of Rehabilitation Medicine, Maastricht University, Maastricht, the Netherlands; Adelante, Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, the Netherlands.
Henk A M
HA
Seelen
D061725:Accelerometry; D000368:Aged; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function / Q000502:physiology*; D012371:Robotics; D016037:Single-Blind Method; D020521:Stroke / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome; D034941:Upper Extremity / Q000503:physiopathology*