TY - JOUR
T1 - Combined Clinic-Home Approach for Upper Limb Robotic Therapy after Stroke
T2 - A Pilot Study
AU - Kim, Grace J.
AU - Rivera, Lisa
AU - Stein, Joel
N1 - Funding Information:
Disclosures: J. Stein has served on the scientific advisory board of Myomo, Inc; received nonfinancial support from Tyromotion, Inc; and grant funding from Nexstim, Inc. The other authors have nothing to disclose.
Publisher Copyright:
© 2015 American Congress of Rehabilitation Medicine.
Copyright:
Copyright 2016 Elsevier B.V., All rights reserved.
PY - 2015/12
Y1 - 2015/12
N2 - Objective To investigate the feasibility of a combined clinic-home intervention using a robotic elbow brace and, secondarily, to collect preliminary data on the efficacy of this clinic-home intervention. Design Nonrandomized pre-/postinterventional study. Setting Outpatient clinic and participants' homes. Participants Individuals at least 6 months after stroke (N=11; 5 women and 6 men; mean age, 51.7y; mean time since stroke, 7.6y; mean Fugl-Meyer Assessment of the Upper Extremity [FMA-UE] score, 22 of 66) were enrolled from the community. Interventions Participants received training in an outpatient clinic from an experienced occupational therapist to gain independence with use of the device (3-9 sessions) followed by a 6-week home program using the device at home. Main Outcome Measures Five instruments were administered before and after the study intervention: Modified Ashworth Scale, Box and Blocks test, FMA-UE, Arm Motor Ability Test, and Motor Activity Log-Amount of Use and Motor Activity Log-How Well subscales (MAL-AOU, MAL-HW). Results Nine participants completed the study. Participants used the device on average 42.9min/d, 5.3d/wk. The FMA-UE (t=3.32; P=.01), MAL-AOU (t=4.40; P=.002), and MAL-HW (t=4.02; P=.004) scores showed statistically significant improvement from baseline to discharge; the MAL-AOU (t=2.61; P=.035) and MAL-HW (t=2.47; P=.043) scores were also significantly improved from baseline to 3-month follow-up. Conclusions This combined clinic-home intervention was feasible and effective. Participants demonstrated improvements in arm impairment and self-reported use of the arm from baseline to discharge; they continued to report significant improvement in actual use of the arm at 3-month follow-up.
AB - Objective To investigate the feasibility of a combined clinic-home intervention using a robotic elbow brace and, secondarily, to collect preliminary data on the efficacy of this clinic-home intervention. Design Nonrandomized pre-/postinterventional study. Setting Outpatient clinic and participants' homes. Participants Individuals at least 6 months after stroke (N=11; 5 women and 6 men; mean age, 51.7y; mean time since stroke, 7.6y; mean Fugl-Meyer Assessment of the Upper Extremity [FMA-UE] score, 22 of 66) were enrolled from the community. Interventions Participants received training in an outpatient clinic from an experienced occupational therapist to gain independence with use of the device (3-9 sessions) followed by a 6-week home program using the device at home. Main Outcome Measures Five instruments were administered before and after the study intervention: Modified Ashworth Scale, Box and Blocks test, FMA-UE, Arm Motor Ability Test, and Motor Activity Log-Amount of Use and Motor Activity Log-How Well subscales (MAL-AOU, MAL-HW). Results Nine participants completed the study. Participants used the device on average 42.9min/d, 5.3d/wk. The FMA-UE (t=3.32; P=.01), MAL-AOU (t=4.40; P=.002), and MAL-HW (t=4.02; P=.004) scores showed statistically significant improvement from baseline to discharge; the MAL-AOU (t=2.61; P=.035) and MAL-HW (t=2.47; P=.043) scores were also significantly improved from baseline to 3-month follow-up. Conclusions This combined clinic-home intervention was feasible and effective. Participants demonstrated improvements in arm impairment and self-reported use of the arm from baseline to discharge; they continued to report significant improvement in actual use of the arm at 3-month follow-up.
KW - Paresis
KW - Rehabilitation
KW - Robotics
KW - Stroke
KW - clinic-home approach
KW - combined approach
KW - upper limb
KW - upper limb robotic therapy
KW - robotic therapy
KW - post-stroke
KW - clinic-home intervention
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U2 - 10.1016/j.apmr.2015.06.019
DO - 10.1016/j.apmr.2015.06.019
M3 - Article
C2 - 26189202
AN - SCOPUS:84947867327
SN - 0003-9993
VL - 96
SP - 2243
EP - 2248
JO - Archives of Physical Medicine and Rehabilitation
JF - Archives of Physical Medicine and Rehabilitation
IS - 12
ER -