Journal of Rehabilitation Research & Development (JRRD)

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Volume 48 Number 4, 2011
   Pages 445 — 458

Abstract —  Robot-assisted upper-limb therapy in acute rehabilitation setting following stroke: Department of Veterans Affairs multisite clinical trial

Charles G . Burgar, MD;1* Peter S. Lum, PhD;2 A. M. Erika Scremin, MD;3 Susan L. Garber, MA, OTR;4
H. F. Machiel Van der Loos, PhD;5-6 Deborah Kenney, MS, OTR;5 Peggy Shor, OTR5

1Central Texas Veterans Health Care System, Temple, TX, and Department of Mechanical Engineering and Material Sciences, Rice University, Houston, TX; 2Washington DC Department of Veterans Affairs (VA) Medical Center, and Department of Biomedical Engineering, Catholic University of America, Washington, DC; 3VA Greater Los Angeles Healthcare System, and University of California at Los Angeles, Los Angeles, CA; 4Michael E. DeBakey VA Medical Center, and Baylor College of Medicine, Houston, TX; 5VA Palo Alto Health Care System, Palo Alto, CA; 6Department of Mechanical Engineering, Stanford University, Stanford, CA

Abstract — This randomized, controlled, multisite Department of Veterans Affairs clinical trial assessed robot-assisted (RA) upper-limb therapy with the Mirror Image Movement Enabler (MIME) in the acute stroke rehabilitation setting. Hemiparetic subjects (n = 54) received RA therapy using MIME for either up to 15 hours (low-dose) or 30 hours (high-dose) or received up to 15 hours of additional conventional therapy in addition to usual care (control). The primary outcome measure was the Fugl-Meyer Assessment (FMA). The secondary outcome measures were the Functional Independence Measure (FIM), Wolf Motor Function Test, Motor Power, and Ashworth scores at intake, discharge, and 6-month follow-up. Mean duration of study treatment was 8.6, 15.8, and 9.4 hours for the low-dose, high-dose, and control groups, respectively. Gains in the primary outcome measure were not significantly different between groups at follow-up. Significant correlations were found at discharge between FMA gains and the dose and intensity of RA. Intensity also correlated with FMA gain at 6 months. The high-dose group had greater FIM gains than controls at discharge and greater tone but no difference in FIM changes compared with low-dose subjects at 6 months. As used during acute rehabilitation, motor-control changes at follow-up were no less with MIME than with additional conventional therapy. Intensity of training with MIME was positively correlated with motor-control gains.

Clinical Trial Registration: ClinicalTrials.gov, NCT00223808, "Assisted Movement Neuro-rehabilitation: VA Multi-site Clinical Trial"; http://www.clinicaltrials.gov/ct2/show/NCT00223808

Key words: acute, arm, bilateral, dose-response, hemiparesis, intensity, rehabilitation, robotics, stroke, therapy.


View HTML  ¦  View PDF  ¦  Contents Vol. 48, No. 4
This article and any supplementary material should be cited as follows:
Burgar CG , Lum PS, Scremin AME, Garber SL, Van der Loos HFM, Kenney D, Shor P. Robot-assisted upper-limb therapy in acute rehabilitation setting following stroke: Department of Veterans Affairs multisite clinical trial. J Rehabil Res Dev. 2011;48(4):445-58.
DOI:10.1682/JRRD.2010.04.0062
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Last Reviewed or Updated  Monday, May 9, 2011 11:34 AM

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