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Arch Phys Med Rehabil. 2011 Nov;92(11):1754-61. doi: 10.1016/j.apmr.2011.06.016. Epub 2011 Aug 17.

Effect of gravity on robot-assisted motor training after chronic stroke: a randomized trial.

Author information

1
Veterans Affairs Maryland Health Care System, Research Service, University of Maryland School of Medicine, Baltimore, USA. susan.conroy@va.gov

Abstract

OBJECTIVES:

To determine the efficacy of 2 distinct 6-week robot-assisted reaching programs compared with an intensive conventional arm exercise program (ICAE) for chronic, stroke-related upper-extremity (UE) impairment. To examine whether the addition of robot-assisted training out of the horizontal plane leads to improved outcomes.

DESIGN:

Randomized controlled trial, single-blinded, with 12-week follow-up.

SETTING:

Research setting in a large medical center.

PARTICIPANTS:

Adults (N=62) with chronic, stroke-related arm weakness stratified by impairment severity using baseline UE motor assessments.

INTERVENTIONS:

Sixty minutes, 3 times a week for 6 weeks of robot-assisted planar reaching (gravity compensated), combined planar with vertical robot-assisted reaching, or intensive conventional arm exercise program.

MAIN OUTCOME MEASURE:

UE Fugl-Meyer Assessment (FMA) mean change from baseline to final training.

RESULTS:

All groups showed modest gains in the FMA from baseline to final with no significant between group differences. Most change occurred in the planar robot group (mean change ± SD, 2.94 ± 0.77; 95% confidence interval [CI], 1.40-4.47). Participants with greater motor impairment (n=41) demonstrated a larger difference in response (mean change ± SD, 2.29 ± 0.72; 95% CI, 0.85-3.72) for planar robot-assisted exercise compared with the intensive conventional arm exercise program (mean change ± SD, 0.43 ± 0.72; 95% CI, -1.00 to 1.86).

CONCLUSIONS:

Chronic UE deficits because of stroke are responsive to intensive motor task training. However, training outside the horizontal plane in a gravity present environment using a combination of vertical with planar robots was not superior to training with the planar robot alone.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT00333983.

PMID:
21849168
PMCID:
PMC4556241
DOI:
10.1016/j.apmr.2011.06.016
[Indexed for MEDLINE]
Free PMC Article

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