Article

OBJECTIVES: To determine the efficacy of 2 distinct 6-week robot-assisted
reaching programs compared with an intensive conventional arm exercise program
(ICAE) for chronic, stroke-related upper-extremity (UE) impairment. To examine
whether the addition of robot-assisted training out of the horizontal plane leads
to improved outcomes. DESIGN: Randomized controlled trial, single-blinded, with
12-week follow-up. SETTING: Research setting in a large medical center.
PARTICIPANTS: Adults (N=62) with chronic, stroke-related arm weakness stratified
by impairment severity using baseline UE motor assessments. INTERVENTIONS: Sixty
minutes, 3 times a week for 6 weeks of robot-assisted planar reaching (gravity
compensated), combined planar with vertical robot-assisted reaching, or intensive
conventional arm exercise program. MAIN : UE Fugl-Meyer Assessment
(FMA) mean change from baseline to final training. RESULTS: All groups showed
modest gains in the FMA from baseline to final with no significant between group
differences. Most change occurred in the planar robot group (mean change +/- SD,
2.94 +/- 0.77; 95% confidence interval [CI], 1.40-4.47). Participants with
greater motor impairment (n=41) demonstrated a larger difference in response
(mean change +/- SD, 2.29 +/- 0.72; 95% CI, 0.85-3.72) for planar robot-assisted
exercise compared with the intensive conventional arm exercise program (mean
change +/- SD, 0.43 +/- 0.72; 95% CI, -1.00 to 1.86). CONCLUSIONS: Chronic UE
deficits because of stroke are responsive to intensive motor task training.
However, training outside the horizontal plane in a gravity present environment
using a combination of vertical with planar robots was not superior to training
with the planar robot alone.
CI - Copyright (c) 2011 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS