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Logo for the Journal of Rehab R&D
Volume 43 Number 5, August/September 2006
Pages 631 — 642


Abstract - MIME robotic device for upper-limb neurorehabilitation in subacute stroke subjects: A follow-up study

Peter S. Lum, PhD;1-2* Charles G. Burgar, MD;3 Machiel Van der Loos, PhD;4 Peggy C. Shor, OTR;4 Matra Majmundar, OTR;4 Ruth Yap, MS4

1Hunter Holmes McGuire Department of Veterans Affairs (VA) Medical Center, Richmond, VA; 2Biomedical Engineering, The Catholic University of America, Washington, DC; 3Central Texas Veterans Health Care System, Temple, TX; 4VA Palo Alto Health Care System, Palo Alto, CA
Abstract — This study presents results from a randomized controlled clinical trial of the Mirror Image Movement Enabler (MIME) robotic device for shoulder and elbow neurorehabilitation in subacute stroke patients, including data on the use of its bilateral training mode. MIME incorporates a PUMA 560 robot (Staubli Unimation Inc, Duncan, South Carolina) that applies forces to the paretic limb during unilateral and bilateral movements in three dimensions. Robot-assisted treatment (bilateral, unilateral, and combined bilateral and unilateral) was compared with conventional therapy. Similar to a previous study in chronic stroke, combined unilateral and bilateral robotic training had advantages compared with conventional therapy, producing larger improvements on a motor impairment scale and a measure of abnormal synergies. However, gains in all treatment groups were equivalent at the 6-month follow-up. Combined unilateral and bilateral training yielded functional gains that were similar to the gains from equivalent doses of unilateral-only robotic training, although the combined group had more hypertonia and less movement out of synergy at baseline. Robot-assisted treatment gains exceeded those expected from spontaneous recovery. These results are discussed in light of the need for further device development and continued clinical trials.
Key words: arm, bilateral, hemiparesis, movement, neurorehabilitation, rehabilitation, robotics, stroke, subacute, therapy, training.

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