Article

Although bilateral arm training (BAT) has been widely studied, the
comparative effects of therapist-based BAT (TBAT) versus
robot-assisted BAT
(RBAT) remains unknown. Objective This study compared the efficacy of TBAT, RBAT,
and a control treatment (CT)
on motor control, functional performance, and
quality of life after chronic stroke. Design A randomized, pretest-posttest,
control group design was used. METHODS: /b> Forty-two patients (mean age=54.49
years, SD=9.69; mean length of time since stroke onset=17.62 months, SD=10.50)
were randomly assigned to TBAT, RBAT, and CT groups. Each group received
treatment for 90 to 105 minutes per session, 5 sessions on weekdays, for 4 weeks.
Outcome measures included kinematic analyses, the Fugl-Meyer Assessment (FMA),
the Motor Activity Log, and the Stroke Impact Scale (SIS). RESULTS: /b> Large and
significant effects were found in the kinematic variables, distal part of
upper-limb motor impairment, and certain aspects of quality of life in favor of
TBAT or RBAT. Specifically, the TBAT group demonstrated significantly better
temporal efficiency and smoothness, straighter trunk motion, and less trunk
compensation compared with the CT and RBAT groups. The RBAT group had increased
shoulder flexion compared with the CT and TBAT groups. On the FMA, the TBAT group
showed higher distal part scores than the CT group. On the SIS, the RBAT group
had better strength subscale, physical function domain, and total scores than the
CT group. Limitations This study recruited patients with mild spasticity and
without cognitive impairment. CONCLUSIONS: /b> Compared with CT, TBAT and RBAT
exhibited differential effects on outcome measures. Therapist-based BAT may
improve temporal efficiency, smoothness, trunk control, and motor impairment of
the distal upper limb. Robot-assisted BAT may improve shoulder flexion and quality of life.

Langue : ANGLAIS