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Volume 42 Number 5, September/October 2005
Pages 683 — 692


Abstract - Short-duration robotic therapy in stroke patients with severe upper-limb motor impairment

Margaret A. Finley, PT, PhD;1-2* Susan E. Fasoli, ScD;3 Laura Dipietro, PhD;3 Jill Ohlhoff, BA;2
Leah MacClellan, MSPH;4 Christine Meister, OTR;1 Jill Whitall, PhD;2 Richard Macko, MD;1,5-6
Christopher T. Bever Jr., MD;1,5-6 Hermano I. Krebs, PhD;3,7 Neville Hogan, PhD3,8

1Department of Veterans Affairs (VA) Maryland Healthcare System, Rehabilitation Research and Development
Service, Baltimore, MD; 2Department of Physical Therapy and Rehabilitation Science, University of Maryland School of Medicine (UMSOM), Baltimore, MD; 3Mechanical Engineering Department, Massachusetts Institute of Technology (MIT), Cambridge, MA; 4Department of Epidemiology and Preventive Medicine, and 5Department of Neurology, UMSOM, Baltimore, MD; 6Department of Neurology, VA Maryland Healthcare System, Baltimore, MD; 7Department of Neurology and Neuroscience, Burke Medical Research Institute, Weill Medical College of Cornell University, White Plains, NY; 8Brain and Cognitive Science Department, MIT, Cambridge, MA
Abstract — Chronic motor deficits in the upper limb (UL) are a major contributor to disability following stroke. This study investigated the effect of short-duration robot-assisted therapy on motor impairment, as measured by clinical scales and robot-derived performance measures in patients with chronic, severe UL impairments after stroke. As part of a larger study, 15 individuals with chronic, severe UL paresis (Fugl-Meyer < 15) after stroke (minimum 6 mo postonset) performed 18 sessions of robot-assisted UL rehabilitation that consisted of goal-directed planar reaching tasks over a period of 3 weeks. Outcome measures included the Fugl-Meyer Assessment, the Motor Power Assessment, the Wolf Motor Function Test, the Stroke Impact Scale, and five robot-derived measures that reflect motor control (aiming error, mean speed, peak speed, mean:peak speed ratio, and movement duration). Robot-assisted training produced statistically significant improvements from baseline to posttreatment in the Fugl-Meyer and Motor Power Assessment scores and the quality of motion (quantified by a reduction in aiming error and movement duration with an increase in mean speed and mean:peak speed ratio). Our findings indicate that robot-assisted UL rehabilitation can reduce UL impairment and improve motor control in patients with severe UL paresis from chronic stroke.
Key words: motor impairment, motor performance measures, neuromotor recovery, neurorehabilitation, rehabilitation robotics, robot-assisted therapy, severe hemiparesis, stroke recovery, upper-limb paresis.

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