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Sci Rep. 2018 Feb 1;8(1):2091. doi: 10.1038/s41598-018-20330-3.

Comparison of proximal versus distal upper-limb robotic rehabilitation on motor performance after stroke: a cluster controlled trial.

Hsieh YW1,2,3, Lin KC4,5, Wu CY6,7,8, Shih TY1, Li MW9, Chen CL3,10.

Author information

1
Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
2
Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan.
3
Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Linkou, Taiwan.
4
School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.
5
Division of Occupational Therapy, Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan.
6
Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan. cywu@mail.cgu.edu.tw.
7
Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan. cywu@mail.cgu.edu.tw.
8
Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Linkou, Taiwan. cywu@mail.cgu.edu.tw.
9
Department of Physical Medicine and Rehabilitation, Sijhih Cathay General Hospital, New Taipei City, Taiwan.
10
Graduate Institute of Early Intervention, College of Medicine, Chang Gung University, Taoyuan, Taiwan.

Abstract

This study examined the treatment efficacy of proximal-emphasized robotic rehabilitation by using the InMotion ARM (P-IMT) versus distal-emphasized robotic rehabilitation by using the InMotion WRIST (D-IMT) in patients with stroke. A total of 40 patients with stroke completed the study. They received P-IMT, D-IMT, or control treatment (CT) for 20 training sessions. Primary outcomes were the Fugl-Meyer Assessment (FMA) and Medical Research Council (MRC) scale. Secondary outcomes were the Motor Activity Log (MAL) and wrist-worn accelerometers. The differences on the distal FMA, total MRC, distal MRC, and MAL quality of movement scores among the 3 groups were statistically significant (P = 0.02 to 0.05). Post hoc comparisons revealed that the D-IMT group significantly improved more than the P-IMT group on the total MRC and distal MRC. Furthermore, the distal FMA and distal MRC improved more in the D-IMT group than in the CT group. Our findings suggest that distal upper-limb robotic rehabilitation using the InMotion WRIST system had superior effects on distal muscle strength. Further research based on a larger sample is needed to confirm long-term treatment effects of proximal versus distal upper-limb robotic rehabilitation.

PMID:
29391492
PMCID:
PMC5794971
DOI:
10.1038/s41598-018-20330-3
[Indexed for MEDLINE]
Free PMC Article

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