title: The HAAPI (Home Arm Assistance Progression Initiative) Trial: A Novel Robotics Delivery Approach in Stroke Rehabilitation.
abstract: BACKGROUND
  Geographical location, socioeconomic status, and logistics surrounding transportation impede access of poststroke individuals to comprehensive rehabilitative services. Robotic therapy may enhance telerehabilitation by delivering consistent and state-of-the art therapy while allowing remote monitoring and adjusting therapy for underserved populations. The Hand Mentor Pro (HMP) was incorporated within a home exercise program (HEP) to improve upper-extremity (UE) functional capabilities poststroke.
  
  
  OBJECTIVE
  To determine the efficacy of a home-based telemonitored robotic-assisted therapy as part of a HEP compared with a dose-matched HEP-only intervention among individuals less than 6 months poststroke and characterized as underserved.
  
  
  METHODS
  In this prospective, single-blinded, multisite, randomized controlled trial, 99 hemiparetic participants with limited access to UE rehabilitation were randomized to either (1) the experimental group, which received combined HEP and HMP for 3 h/d ×5 days ×8 weeks, or (2) the control group, which received HEP only at an identical dosage. Weekly communication between the supervising therapist and participant promoted compliance and progression of the HEP and HMP prescription. The Action Research Arm Test and Wolf Motor Function Test along with the Fugl-Meyer Assessment (UE) were primary and secondary outcome measures, respectively, undertaken before and after the interventions.
  
  
  RESULTS
  Both groups demonstrated improvement across all UE outcomes.
  
  
  CONCLUSIONS
  Robotic + HEP and HEP only were both effectively delivered remotely. There was no difference between groups in change in motor function over time. Additional research is necessary to determine the appropriate dosage of HMP and HEP.
authors.affiliation: Emory University School of Medicine, Atlanta, GA, USA Atlanta VA Medical Center, Decatur, GA, USA swolf@emory.edu.
authors.forename: Steven L
authors.initials: SL
authors.lastname: Wolf
authors.affiliation: Emory University School of Medicine, Atlanta, GA, USA.
authors.forename: Komal
authors.initials: K
authors.lastname: Sahu
authors.affiliation: A. T. Still University, Mesa AZ, USA.
authors.forename: R Curtis
authors.initials: RC
authors.lastname: Bay
authors.affiliation: Scottsdale Healthcare, Scottsdale, AZ, USA.
authors.forename: Sharon
authors.initials: S
authors.lastname: Buchanan
authors.affiliation: Emory University School of Medicine, Atlanta, GA, USA.
authors.forename: Aimee
authors.initials: A
authors.lastname: Reiss
authors.affiliation: Cleveland Clinic, OH, USA.
authors.forename: Susan
authors.initials: S
authors.lastname: Linder
authors.affiliation: Cleveland Clinic, OH, USA.
authors.forename: Anson
authors.initials: A
authors.lastname: Rosenfeldt
authors.affiliation: Cleveland Clinic, OH, USA Louis Stokes Cleveland VA Medical Center, Cleveland, OH, USA.
authors.forename: Jay
authors.initials: J
authors.lastname: Alberts
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001132:Arm / Q000502:physiology*; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D010291:Paresis / Q000209:etiology / Q000534:rehabilitation; D011446:Prospective Studies; D012189:Retrospective Studies; D012371:Robotics; D012720:Severity of Illness Index; D016037:Single-Blind Method; D020521:Stroke / Q000150:complications; D000071939:Stroke Rehabilitation; D000069350:Telerehabilitation; D016896:Treatment Outcome
keywords: hemiparesis; robotics; stroke; telerehabilitation; therapy; upper extremity