A comparison of functional and impairment-based robotic training in severe to moderate chronic stroke: a pilot study.
ABSTRACT To compare the outcome of training the functional movement of transport of the arm and grasping an object with the alternative of training the transport of the arm in isolation.
Rehabilitation hospitals, outpatient care.
Volunteer sample of forty-seven persons with persistent hemiparesis from a single, unilateral stroke within the past one to five years.
Robotic therapy 3 x/week for 6 weeks for the paretic upper limb consisted of either a) sensorimotor, active-assistive impairment-based exercise during repetitive planar reaching tasks, or b) a "free-hand" approach, in which the robot assisted subjects employing the sensorimotor active-assistive exercise to transport the hand to a series of targets, where it stopped to allow the person to interact with actual objects (functional approach 1), or c) transport and manipulation, in which the robot assisted subjects employing active-assistive exercise during repetitive planar reaching tasks while grasping a simulated object and releasing it at the target or followed by grasp and release of a simulated object (functional approach 2).
Fugl-Meyer Assessment. Results: All three groups improved from pre- to post-treatment with the sensorimotor impairment based approach demonstrating the best outcome of the three approaches.
Short-term, goal-directed robotic therapy can significantly improve motor abilities of the exercised limb segments in persons with chronic stroke, but contrary to expectation, training both the transport of the arm and manipulation of an object (functionally-based approaches) did not confer any advantage over training solely transport of the arm (impairment-based approach).
- SourceAvailable from: Soha Saleh
Dataset: Qiu et al NJITRAVR paper
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ABSTRACT: BACKGROUND: . Knowledge of how damage to brain regions and pathways affects central nervous system control of coordination of reach-to-grasp (RTG) following stroke may not be sufficiently used in existing treatment interventions or in research that assesses their effectiveness. OBJECTIVE: . To review current knowledge of motor control of coordination of RTG and discuss the extent to which this information is being used in research evaluating treatment interventions. METHOD: . This review (1) summarizes the current knowledge of motor control of RTG coordination in healthy individuals, including speculative models and structures of the brain identified as being involved; (2) summarizes evidence of RTG coordination deficits in people with stroke; (3) evaluates current interventions directed at retraining coordination of RTG, including a review of the extent to which these interventions are based on putative neurobiological mechanisms and reports on their effectiveness; and (4) recommends directions for research on treatment interventions for coordination of RTG. RESULTS: . Functional task-specific therapy, electrical stimulation, and robot or computerized training were identified as treatments targeted at improving coordination of RTG. However, none of the studies reporting the effect of these interventions related results to individual brain regions affected, and neurobiological mechanisms underlying improved performance were only minimally discussed. CONCLUSIONS: . Research on treatment interventions for coordination of RTG needs to combine measures of interruption to brain networks and how remaining intact neural tissue and networks respond to therapy with measures of spatiotemporal motor control and upper-limb function to gain a fuller understanding of treatment effects and their mechanisms.Neurorehabilitation and neural repair 04/2013; · 4.28 Impact Factor
- Annales Academiae Medicae Silesiensis. 10/2012;