Volume 43 Number 3, May/June 2006
Pages 391 — 400
Abstract - A telerehabilitation approach to delivery of constraint-induced movement
Peter S. Lum, PhD;1-2* Gitendra Uswatte, PhD;3 Edward Taub, PhD;3-4 Phillip Hardin, MS;4 Victor W. Mark, MD5
1Hunter Holmes McGuire Department of Veterans Affairs Medical Center (VAMC), Richmond, VA; 2Biomedical
Engineering, Virginia Commonwealth University, Richmond, VA; 3Department of Psychology, University of Alabama at Birmingham, Birmingham, AL; 4Birmingham VAMC, Birmingham, AL; 5Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham, Birmingham, AL
Abstract — We have developed a device called AutoCITE (Automated Constraint-Induced Therapy Extension) that automates the intensive training component of constraint-induced (CI) movement therapy, also known as CI therapy. This study evaluated the effectiveness of AutoCITE training in a telerehabilitation setting when supervised remotely and with only intermittent interaction with a therapist. Seven participants with chronic stroke trained with AutoCITE for 3 h/d for 10 consecutive weekdays. The therapist supervised the training from a different room in the clinic using remote control of the AutoCITE computer and teleconferencing equipment when needed. Treatment gains on the Motor Activity Log were quite large (p < 0.001, d´ = 3), while gains on the Wolf Motor Function Test and the Jebsen-Taylor Hand Function Test were large (p < 0.05, d´ > 0.9). Gains were comparable in size with those previously reported for participants who received equal intensities of directly supervised AutoCITE training or standard one-on-one CI therapy without the device.
Key words: arm, automated treatment, CI therapy, hemiparesis, motor recovery, rehabilitation, robotics, stroke, technology, telerehabilitation.