scholarly journals Multicenter Randomized Trial of Robot-Assisted Rehabilitation for Chronic Stroke: Methods and Entry Characteristics for VA ROBOTICS

2009 ◽  
Vol 23 (8) ◽  
pp. 775-783 ◽  
Author(s):  
Albert C. Lo ◽  
Peter Guarino ◽  
Hermano I. Krebs ◽  
Bruce T. Volpe ◽  
Christopher T. Bever ◽  
...  
Keyword(s):  
Upper Extremity ◽  
Motor Function ◽  
Controlled Trial ◽  
Chronic Stroke ◽  
Robot Assisted ◽  
Anterior Circulation ◽  
Multicenter Randomized Controlled Trial ◽  
Index Stroke ◽  
Wolf Motor Function Test ◽  
Upper Extremity Impairment

Background. Chronic upper extremity impairment due to stroke has significant medical, psychosocial, and financial consequences, but few studies have examined the effectiveness of rehabilitation therapy during the chronic stroke period. Objective. To test the safety and efficacy of the MIT-Manus robotic device for chronic upper extremity impairment following stroke. Methods. The VA Cooperative Studies Program initiated a multicenter, randomized, controlled trial in November 2006 (VA ROBOTICS). Participants with upper extremity impairment ≥6 months poststroke were randomized to robot-assisted therapy (RT), intensive comparison therapy (ICT), or usual care (UC). RT and ICT consisted of three 1-hour treatment sessions per week for 12 weeks. The primary outcome was change in the Fugl-Meyer Assessment upper extremity motor function score at 12 weeks relative to baseline. Secondary outcomes included the Wolf Motor Function Test and the Stroke Impact Scale. Results. A total of 127 participants were randomized: 49 to RT, 50 to ICT, and 28 to UC. The majority of participants were male (96%), with a mean age of 65 years. The primary stroke type was ischemic (85%), and 58% of strokes occurred in the anterior circulation. Twenty percent of the participants reported a stroke in addition to their index stroke. The average time from the index stroke to enrollment was 56 months (range, 6 months to 24 years). The mean Fugl-Meyer score at entry was 18.9. Conclusions. VA ROBOTICS demonstrates the feasibility of conducting multicenter clinical trials to rigorously test new rehabilitative devices before their introduction to clinical practice. The results are expected in early 2010.

scholarly journals The effect of the Bobath therapy programme on upper limb and hand function in chronic stroke individuals with moderate to severe deficits

2019 ◽  
Vol 26 (10) ◽  
pp. 1-12
Author(s):  
Thanchanok Pumprasart ◽  
Noppol Pramodhyakul ◽  
Pagamas Piriyaprasarth
Keyword(s):  
Upper Extremity ◽  
Motor Function ◽  
Upper Limb ◽  
Muscle Tone ◽  
Chronic Stroke ◽  
Rank Test ◽  
Limb Function ◽  
Function Test ◽  
Wolf Motor Function Test ◽  
Therapy Programme

Background/Aims The Bobath concept has long been used to improve postural control and limb function post-stroke, yet its effect in patients with deficits have not been clearly demonstrated. This study aimed to investigate the effect of the latest Bobath therapy programme on upper limb functions, muscle tone and sensation in chronic stroke individuals with moderate to severe deficits. Methods A pre–post test design was implemented. The participants were chronic stroke individuals (n=26). Home-based intervention based on the Bobath concept was administered 3 days per week for 6 weeks (20 repetitions × 3 sets per task each session). Outcome measures consisted of the Wolf Motor Function Test, Fugl-Meyer Assessment for the upper extremity, Modified Ashworth Scale, and the Revised Nottingham Sensory Assessment. Data were analysed using the Wilcoxon Signed rank test. Results Almost all items of the Wolf Motor Function Test and the Fugl-Meyer Assessment for the upper extremity demonstrated statistically significant differences post-intervention. Finger flexor muscle tone and stereognosis were also significantly improved. Conclusions The 6-week Bobath therapy programme could improve upper limb function and impairments in chronic stroke individuals with moderate to severe deficits. Its effects were also demonstrated in improving muscle tone and cortical sensation.

scholarly journals The extent of altered digit force direction correlates with clinical upper extremity impairment in chronic stroke survivors

2015 ◽  
Vol 48 (2) ◽  
pp. 383-387 ◽  
Author(s):  
Na Jin Seo ◽  
Leah R. Enders ◽  
Binal Motawar ◽  
Marcella L. Kosmopoulos ◽  
Mojtaba Fathi-Firoozabad
Keyword(s):  
Upper Extremity ◽  
Chronic Stroke ◽  
Stroke Survivors ◽  
Force Direction ◽  
Upper Extremity Impairment

Effects of Proximal Priority and Distal Priority Robotic Priming Techniques With Impairment-Oriented Training of Upper Limb Functions in Patients With Chronic Stroke: Study Protocol For A Single-Blind, Randomized Controlled Trial

2021 ◽  
Author(s):  
Yi-chen Lee ◽  
Yi-chun Li ◽  
KEH-CHUNG LIN ◽  
Chia-ling Chen ◽  
Yi-hsuan Wu ◽  
...  
Keyword(s):  
Upper Extremity ◽  
Repeated Measures ◽  
Controlled Trial ◽  
Scientific Evidence ◽  
Body Part ◽  
Chronic Stroke ◽  
Comparative Efficacy ◽  
Chi Square ◽  
Robotic Therapy ◽  
Single Blind

Abstract BackgroundThe sequence of establishing proximal stability or function before facilitation of the distal body part has long been recognized in stroke rehabilitation practice but lacks scientific evidence. This study plans to examine the effects of proximal priority robotic priming and impairment-oriented training (PRI) and distal priority robotic priming and impairment-oriented training (DRI). MethodsThis single-blind, randomized, comparative efficacy study will involve 40 participants with chronic stroke. Participants will be randomized into PRI or DRI groups and receive 18 intervention sessions (90 min/d, 3 d/wk for 6 weeks). The Fugl-Meyer Assessment Upper Extremity subscale, Medical Research Council Scale, Revised Nottingham Sensory Assessment, and Wolf Motor Function Test will be administered at baseline, after treatment, and at the 3-month follow-up. Two-way repeated-measures analysis of variance and the chi-square automatic interaction detector method will be used to examine the comparative efficacy and predictors of outcome, respectively, after PRI and DRI. DiscussionThrough manipulating the sequence of applying wrist and forearm robots in therapy, this study will attempt to examine empirically the priming effect of proximal or distal priority robotic therapy in upper extremity impairment-oriented training for people with stroke. The findings will provide directions for further studies and empirical implications for clinical practice in upper extremity rehabilitation after stroke.Trial RegistrationThis trial was registered on June 23, 2020, at www.clinicaltrials.gov (NCT04446273).

scholarly journals Action Observation Treatment-Based Exoskeleton (AOT-EXO) for Upper Extremity After Stroke: Study Protocol for a Randomised Controlled Trial

2021 ◽  
Author(s):  
Zejian Chen ◽  
Nan Xia ◽  
Chang He ◽  
Minghui Gu ◽  
Jiang Xu ◽  
...  
Keyword(s):  
Upper Extremity ◽  
Functional Disability ◽  
Motor Evoked Potentials ◽  
Action Observation ◽  
Controlled Trial ◽  
Measurement Unit ◽  
Motor Deficit ◽  
Robot Assisted ◽  
Clinical Trial Registry ◽  
Resting Motor Threshold

Abstract Background Stroke produces multiple symptoms, including sensory, motor, cognitive and psychological dysfunctions, among which motor deficit is the most common and is widely recognized as a major contributor to long-term functional disability. Robot-assisted training is effective in promoting upper extremity muscle strength and motor impairment recovery after stroke. Additionally, action observation treatment can enhance the effects of physical and occupational therapy by increasing neural activation. The AOT-EXO trial aims to investigate whether action observation treatment coupled with robot-assisted training could enhance motor circuit activation and improve upper extremity motor outcomes. Methods The AOT-EXO trial is a multicentre, prospective, three-group randomized controlled trial (RCT). We will screen and enrol 132 eligible patients in the trial implemented in the Department of Rehabilitation Medicine of Tongji Hospital, Optical Valley Branch of Tongji Hospital and Hubei Province Hospital of Integrated Chinese & Western Medicine in Wuhan, China. Prior to study participation, written informed consent will be obtained from eligible patients in accordance with the Declaration of Helsinki. The enrolled stroke patients will be randomised to three groups: the CT group (conventional therapy); EXO group (exoskeleton therapy) and AOT-EXO group (action observation treatment-based exoskeleton therapy). The patients will undergo blinded assessments at baseline, post-intervention (after 4 weeks) and follow-up (after 12 weeks). The primary outcome will be the Fugl-Meyer Assessment for Upper Extremity (FMA-UE). Secondary outcomes will include the Action Research Arm Test (ARAT), modified Barthel Index (MBI), kinematic metrics assessed by inertial measurement unit (IMU), resting motor threshold (rMT), motor evoked potentials (MEP), functional magnetic resonance imaging (fMRI) and safety outcomes. Discussion This trial will provide evidence regarding the feasibility and efficacy of the action observation treatment-based exoskeleton (AOT-EXO) for post-stroke upper extremity rehabilitation and elucidate the potential underlying kinematic and neurological mechanisms. Trial Registration: Chinese Clinical Trial Registry identifier: ChiCTR1900026656. Registered on 17 October 2019.

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