Effects of robot-assisted upper limb rehabilitation on daily function and real-world arm activity in patients with chronic stroke: a randomized controlled trial
Patients following a stroke often have weakness on one side of the upper body which can make daily life more difficult. This study outlines how robot-assisted therapy helps arm function to improve after a stroke. It is the first to use accelerometers to track patients’ improvement and compare real world results. 20 patients enrolled in a study comparing robot-assisted therapy combined with functional training against an active control treatment group. Stroke patients usually have difficulties transferring motor skills learned in therapy to their daily living environment because of cognitive deficits. Robotic rehabilitation is increasingly available, and holds promise for enhancing traditional post-stroke interventions. Because robots never tire, they can provide massive and intensive training in a consistent manner without fatigue, with programming precisely tailored to each patient’s needs.
Objective: To compare the outcome of robot-assisted therapy with dose-matched active control therapy by using accelerometers to study functional recovery in chronic stroke patients. Design: Prospective, randomized, controlled trial. Setting: Stroke units in three medical centres.
Subjects: Twenty patients post stroke for a mean of 22 months. Intervention: Robot-assisted therapy (n = 10) or dose-matched active control therapy (n = 10). All patients received either of these two therapies for 90–105 minutes each day, 5 days per week, for four weeks.
Main measures: Outcome measures included arm activity ratio (the ratio of mean activity between the impaired and unimpaired arm) and scores on the Fugl-Meyer Assessment Scale, Functional Independence Measure, Motor Activity Log and ABILHAND questionnaire.
Results: The robot-assisted therapy group significantly increased motor function, hemiplegic arm activity and bilateral arm coordination (Fugl-Meyer Assessment Scale: 51.20 ± 8.82, P = 0.002; mean arm activity ratio: 0.76 ± 0.10, P = 0.026; ABILHAND questionnaire: 1.24 ± 0.28, P = 0.043) compared with the dose-matched active control group (Fugl-Meyer Assessment Scale: 40.90 ± 13.14; mean arm movement ratio: 0.69 ± 0.11; ABILHAND questionnaire: 0.95 ± 0.43).
Conclusions: Symmetrical and bilateral robotic practice, combined with functional task training, can significantly improve motor function, arm activity, and self-perceived bilateral arm ability in patients late after stroke
Liao, W., Wu, C., Hsieh, Y., Lin, K., & Chang, W. (2011). Effects of robot-assisted upper limb rehabilitation on daily function and real-world arm activity in patients with chronic stroke: a randomized controlled trial Clinical Rehabilitation DOI: 10.1177/0269215511416383