| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
From the Department of Neurology and Neuroscience (Dr. Volpe), Cornell University Medical College, Burke Institute of Medical Research, White Plains, NY; the Mechanical Engineering Department (Drs. Krebs and Hogan), Newman Laboratory, and Brain and Cognitive Sciences Department (Dr. Hogan), Massachusetts Institute of Technology, Boston; Rehabilitation Research and Development (Dr. Aisen), Department of Veterans Administration, Washington, DC; and the Burke Rehabilitation Hospital (L. Edelstein and C. Diels), White Plains, NY.
Address correspondence and reprint requests to Dr. B.T. Volpe, Cornell University Medical College, Department of Neurology and Neuroscience, Burke Institute of Medical Research, 785 Mamaroneck Avenue, White Plains, NY 10605; volpe{at}rockvax.rockefeller.edu
OBJECTIVE: In patients with stroke, the authors tested whether additional sensorimotor training of the paralyzed or paretic upper limb delivered by a robotic device enhanced motor outcome.
METHODS: Fifty-six patients with stroke and hemiparesis or hemiplegia received standard poststroke multidisciplinary rehabilitation, and were randomly assigned either to receive robotic training (at least 25 hours) or exposure to the robotic device without training. Outcomes were assessed by the same masked raters, before treatment began and at the end of treatment, with the upper extremity component of the Fugl-Meyer Motor Assessment, the Motor Status score, the Motor Power score, and Functional Independence Measurement.
RESULT: The robot treatment and control group had comparable clinical characteristics, lesion size, and pretreatment impairment scores. By the end of treatment, the robot-trained group demonstrated improvement in motor outcome for the trained shoulder and elbow (Motor Power score, p < 0.001; Motor Status score, p < 0.01) that did not generalize to untrained wrist and hand. The robot-treated group also demonstrated significantly improved functional outcome (Functional Independence Measurement–Motor, p < 0.01).
CONCLUSION: Robot-delivered quantitative and reproducible sensorimotor training enhanced the motor performance of the exercised shoulder and elbow. The robot-treated group also demonstrated improved functional outcome. When added to standard multidisciplinary rehabilitation, robotics provides novel therapeutic strategies that focus on impairment reduction and improved motor performance.
Key words: Robotics—Robot—Aids—Stroke—Motor recovery.
This article has been cited by other articles:
|
|
 |
|
  A. C. Lo, P. Guarino, H. I. Krebs, B. T. Volpe, C. T. Bever, P. W. Duncan, R. J. Ringer, T. H. Wagner, L. G. Richards, D. M. Bravata, et al. Multicenter Randomized Trial of Robot-Assisted Rehabilitation for Chronic Stroke: Methods and Entry Characteristics for VA ROBOTICS Neurorehabil Neural Repair, October 1, 2009; 23(8): 775 - 783. [Abstract] [PDF]
|
|
|
|
|
|
A. C. Lo and E. W. Triche Improving Gait in Multiple Sclerosis Using Robot-Assisted, Body Weight Supported Treadmill Training Neurorehabil Neural Repair, November 1, 2008; 22(6): 661 - 671. [Abstract] [PDF]
|
|
|
|
 |
|
 S. Coote, B. Murphy, W. Harwin, and E. Stokes The effect of the GENTLE/s robot-mediated therapy system on arm function after stroke Clinical Rehabilitation, May 1, 2008; 22(5): 395 - 405. [Abstract] [PDF]
|
|
|
|
|
|
G. Kwakkel, B. J. Kollen, and H. I. Krebs Effects of Robot-Assisted Therapy on Upper Limb Recovery After Stroke: A Systematic Review Neurorehabil Neural Repair, April 1, 2008; 22(2): 111 - 121. [Abstract] [PDF]
|
|
|
|
|
|
S. Dechaumont-Palacin, P. Marque, X. De Boissezon, E. Castel-Lacanal, C. Carel, I. Berry, J. Pastor, J.F. Albucher, F. Chollet, and I. Loubinoux Neural Correlates of Proprioceptive Integration in the Contralesional Hemisphere of Very Impaired Patients Shortly After a Subcortical Stroke: An fMRI Study Neurorehabil Neural Repair, April 1, 2008; 22(2): 154 - 165. [Abstract] [PDF]
|
|
|
|
 |
|
 M. Hatakenaka, I. Miyai, S. Sakoda, and T. Yanagihara Proximal paresis of the upper extremity in patients with stroke Neurology, July 24, 2007; 69(4): 348 - 355. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Hesse, C. Werner, M. Pohl, S. Rueckriem, J. Mehrholz, and M.L. Lingnau Computerized Arm Training Improves the Motor Control of the Severely Affected Arm After Stroke: A Single-Blinded Randomized Trial in Two Centers Stroke, September 1, 2005; 36(9): 1960 - 1966. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T Platz, C Eickhof, S van Kaick, U Engel, C Pinkowski, S Kalok, and M Pause Impairment-oriented training or Bobath therapy for severe arm paresis after stroke: a single-blind, multicentre randomized controlled trial Clinical Rehabilitation, July 1, 2005; 19(7): 714 - 724. [Abstract] [PDF]
|
|
|
|
|
|
S. E. Fasoli, H. I. Krebs, M. Ferraro, N. Hogan, and B. T. Volpe Does Shorter Rehabilitation Limit Potential Recovery Poststroke? Neurorehabil Neural Repair, June 1, 2004; 18(2): 88 - 94. [Abstract] [PDF]
|
|
|
|
|
|
H. Feys, W. De Weerdt, G. Verbeke, G. C. Steck, C. Capiau, C. Kiekens, E. Dejaeger, G. Van Hoydonck, G. Vermeersch, and P. Cras Early and Repetitive Stimulation of the Arm Can Substantially Improve the Long-Term Outcome After Stroke: A 5-Year Follow-up Study of a Randomized Trial Stroke, April 1, 2004; 35(4): 924 - 929. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Ferraro, J. J. Palazzolo, J. Krol, H. I. Krebs, N. Hogan, and B. T. Volpe Robot-aided sensorimotor arm training improves outcome in patients with chronic stroke Neurology, December 9, 2003; 61(11): 1604 - 1607. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Barreca, S. L. Wolf, S. Fasoli, and R. Bohannon Treatment Interventions for the Paretic Upper Limb of Stroke Survivors: A Critical Review Neurorehabil Neural Repair, December 1, 2003; 17(4): 220 - 226. [Abstract] [PDF]
|
|
|
|
|
|
J. Chae and R. Hart Intramuscular Hand Neuroprosthesis for Chronic Stroke Survivors Neurorehabil Neural Repair, June 1, 2003; 17(2): 109 - 117. [Abstract] [PDF]
|
|
|
|
 |
|
 J. L Ruhland and P. L. van Kan Medial Pontine Hemorrhagic Stroke Physical Therapy, June 1, 2003; 83(6): 552 - 566. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Barbeau Locomotor Training in Neurorehabilitation: Emerging Rehabilitation Concepts Neurorehabil Neural Repair, March 1, 2003; 17(1): 3 - 11. [PDF]
|
|
|
|
|
|
J. Chae, G. Yang, B. K. Park, and I. Labatia Muscle Weakness and Cocontraction in Upper Limb Hemiparesis: Relationship to Motor Impairment and Physical Disability Neurorehabil Neural Repair, September 1, 2002; 16(3): 241 - 248. [Abstract] [PDF]
|
|
|
|
|
|
M. Ferraro, J. H. Demaio, J. Krol, C. Trudell, K. Rannekleiv, L. Edelstein, P. Christos, M. Aisen, J. England, S. Fasoli, et al. Assessing the Motor Status Score: A Scale for the Evaluation of Upper Limb Motor Outcomes in Patients after Stroke Neurorehabil Neural Repair, September 1, 2002; 16(3): 283 - 289. [Abstract] [PDF]
|
|
|
|
 |
|
 W. M. Landau and S. A. Sahrmann Preservation of Directly Stimulated Muscle Strength in Hemiplegia Due to Stroke Arch Neurol, September 1, 2002; 59(9): 1453 - 1457. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Hallett Recent Advances in Stroke Rehabilitation Neurorehabil Neural Repair, June 1, 2002; 16(2): 211 - 217. [PDF]
|
|
|
|
|
|
J. H van der Lee, I. A. Snels, H. Beckerman, G. J Lankhorst, R. C Wagenaar, and L. M Bouter Exercise therapy for arm function in stroke patients: a systematic review of randomized controlled trials Clinical Rehabilitation, January 1, 2001; 15(1): 20 - 31. [Abstract] [PDF]
|
|
|
|
|
|
F. d. N. A. P. Shelton and M. J. Reding Effect of Lesion Location on Upper Limb Motor Recovery After Stroke Stroke, January 1, 2001; 32(1): 107 - 112. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
