title: Bilateral robotic priming before task-oriented approach in subacute stroke rehabilitation: a pilot randomized controlled trial.
abstract: OBJECTIVE
  To investigate the treatment effects of bilateral robotic priming combined with the task-oriented approach on motor impairment, disability, daily function, and quality of life in patients with subacute stroke.
  
  
  METHODS
  A randomized controlled trial.
  
  
  METHODS
  Occupational therapy clinics in medical centers.
  
  
  METHODS
  Thirty-one subacute stroke patients were recruited.
  
  
  METHODS
  Participants were randomly assigned to receive bilateral priming combined with the task-oriented approach (i.e., primed group) or to the task-oriented approach alone (i.e., unprimed group) for 90 minutes/day, 5 days/week for 4 weeks. The primed group began with the bilateral priming technique by using a bimanual robot-aided device.
  
  
  METHODS
  Motor impairments were assessed by the Fugal-Meyer Assessment, grip strength, and the Box and Block Test. Disability and daily function were measured by the modified Rankin Scale, the Functional Independence Measure, and actigraphy. Quality of life was examined by the Stroke Impact Scale.
  
  
  RESULTS
  The primed and unprimed groups improved significantly on most outcomes over time. The primed group demonstrated significantly better improvement on the Stroke Impact Scale strength subscale ( p = 0.012) and a trend for greater improvement on the modified Rankin Scale ( p = 0.065) than the unprimed group.
  
  
  CONCLUSIONS
  Bilateral priming combined with the task-oriented approach elicited more improvements in self-reported strength and disability degrees than the task-oriented approach by itself. Further large-scale research with at least 31 participants in each intervention group is suggested to confirm the study findings.
authors.affiliation: 1 Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.|2 Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Yu-Wei
authors.initials: YW
authors.lastname: Hsieh
authors.affiliation: 1 Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.|2 Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Ching-Yi
authors.initials: CY
authors.lastname: Wu
authors.affiliation: 1 Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Wei-En
authors.initials: WE
authors.lastname: Wang
authors.affiliation: 3 School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.|4 Division of Occupational Therapy, Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Keh-Chung
authors.initials: KC
authors.lastname: Lin
authors.affiliation: 5 Division of Cerebrovascular Diseases, Department of Neurology, Chang Gung Memorial Hospital, Kaohsiung, Taiwan.|6 Department of Senior Citizen Service Management, Yuh-Ing Junior College, Kaohsiung, Taiwan.|7 Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Ku-Chou
authors.initials: KC
authors.lastname: Chang
authors.affiliation: 7 Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan.|8 Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors.forename: Chih-Chi
authors.initials: CC
authors.lastname: Chen
authors.affiliation: 9 Department of Physical Medicine and Rehabilitation, Taipei Tzuchi Hospital, Buddhist Tzuchi Medical Foundation, New Taipei City, Taiwan.
authors.forename: Chien-Ting
authors.initials: CT
authors.lastname: Liu
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D004185:Disability Evaluation; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009788:Occupational Therapy / Q000295:instrumentation* / Q000379:methods; D010865:Pilot Projects; D011379:Prognosis; D020127:Recovery of Function / Q000502:physiology; D012016:Reference Values; D012371:Robotics; D018709:Statistics, Nonparametric; D020521:Stroke / Q000503:physiopathology; D000071939:Stroke Rehabilitation / Q000379:methods*; D013647:Task Performance and Analysis; D016896:Treatment Outcome; D034941:Upper Extremity / Q000503:physiopathology
keywords: Bilateral priming; robot; stroke rehabilitation; task-oriented approach; upper extremity