Accelerometry measuring the outcome of robot-supported upper limb training in chronic stroke: a randomized controlled trial

• Published in: PloS one 2014-05, Vol.9 (5), p.e96414-e96414
• Main Authors: Lemmens, Ryanne J M, Timmermans, Annick A A, Janssen-Potten, Yvonne J M, Pulles, Sanne A N T D, Geers, Richard P J, Bakx, Wilbert G M, Smeets, Rob J E M, Seelen, Henk A M
• Format: Article
• Language: English
• Subjects: Accelerometers; Accelerometry; Activities of daily living; Aged; Arm; Audiology; Biology and Life Sciences; Clinical trials; Control methods; Engineering and Technology; Exercise Therapy - methods; Female; Humans; Male; Medicine; Medicine and Health Sciences; Middle Aged; Patients; Randomization; Recovery of Function - physiology; Rehabilitation; Research and Analysis Methods; Robotics; Robots; Science Policy; Sensors; Single-Blind Method; Stroke; Stroke - physiopathology; Stroke Rehabilitation; Studies; Training; Treatment Outcome; Upper Extremity - physiopathology
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0096414

This study aims to assess the extent to which accelerometers can be used to determine the effect of robot-supported task-oriented arm-hand training, relative to task-oriented arm-hand training alone, on the actual amount of arm-hand use of chronic stroke patients in their home situation. This single-blind randomized controlled trial included 16 chronic stroke patients, randomly allocated using blocked randomization (n = 2) to receive task-oriented robot-supported arm-hand training or task-oriented (unsupported) arm-hand training. Training lasted 8 weeks, 4 times/week, 2 × 30 min/day using the (T-)TOAT ((Technology-supported)-Task-Oriented-Arm-Training) method. The actual amount of arm-hand use, was assessed at baseline, after 8 weeks training and 6 months after training cessation. Duration of use and intensity of use of the affected arm-hand during unimanual and bimanual activities were calculated. Duration and intensity of use of the affected arm-hand did not change significantly during and after training, with or without robot-support (i.e. duration of use of unimanual use of the affected arm-hand: median difference of -0.17% in the robot-group and -0.08% in the control group between baseline and after training cessation; intensity of the affected arm-hand: median difference of 3.95% in the robot-group and 3.32% in the control group between baseline and after training cessation). No significant between-group differences were found. Accelerometer data did not show significant changes in actual amount of arm-hand use after task-oriented training, with or without robot-support. Next to the amount of use, discrimination between activities performed and information about quality of use of the affected arm-hand are essential to determine actual arm-hand performance. Controlled-trials.com ISRCTN82787126.