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

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...

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Bibliographic Details
Published in:Journal of rehabilitation research and development 2011-01, Vol.48 (4), p.445-458
Main Authors: Burgar, Charles G, Lum, Peter S, Scremin, A M Erika, Garber, Susan L, Van der Loos, H F Machiel, Kenney, Deborah, Shor, Peggy
Format: Article
Language:English
Subjects:
Administrative support
Advantages
Aged
Care and treatment
Clinical trials
Diagnosis
Health aspects
Health care policy
Hospitals, Veterans
Humans
Methods
Middle Aged
Paresis - etiology
Paresis - rehabilitation
Psychomotor Performance
Recovery of Function
Rehabilitation
Robotic surgery
Robotics
Stroke (Disease)
Stroke Rehabilitation
Studies
Systems design
Upper Extremity
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Summary: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.
ISSN:0748-7711
1938-1352
DOI:10.1682/jrrd.2010.04.0062