Objective: To compare the effects of robot-assisted movement training with conventional techniques for the rehabilitation of upper-limb motor function after stroke.
Design: Randomized controlled trial, 6-month follow-up.
Setting: A Department of Veterans Affairs rehabilitation research and development center.
Participants: Consecutive sample of 27 subjects with chronic hemiparesis (>6mo after cerebrovascular accident) randomly allocated to group.
Interventions: All subjects received twenty-four 1-hour sessions over 2 months. Subjects in the robot group practiced shoulder and elbow movements while assisted by a robot manipulator. Subjects in the control group received neurodevelopmental therapy (targeting proximal upper limb function) and 5 minutes of exposure to the robot in each session.
Main outcome measures: Fugl-Meyer assessment of motor impairment, FIMtrade mark instrument, and biomechanic measures of strength and reaching kinematics. Clinical evaluations were performed by a therapist blinded to group assignments.
Results: Compared with the control group, the robot group had larger improvements in the proximal movement portion of the Fugl-Meyer test after 1 month of treatment (P<.05) and also after 2 months of treatment (P<.05). The robot group had larger gains in strength (P<.02) and larger increases in reach extent (P<.01) after 2 months of treatment. At the 6-month follow-up, the groups no longer differed in terms of the Fugl-Meyer test (P>.30); however, the robot group had larger improvements in the FIM (P<.04).
Conclusions: Compared with conventional treatment, robot-assisted movements had advantages in terms of clinical and biomechanical measures. Further research into the use of robotic manipulation for motor rehabilitation is justified.
Copyright 2002 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation