1. Robot-assisted upper-limb therapy in acute rehabilitation setting following stroke: Department of Veterans Affairs multisite clinical trial.
- Author
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Burgar, Charles G., Lum, Peter S., Scremin, A. M. Erika, Garber, Susan L., Van der Loos, H. F. Machiel, Kenney, Deborah, and Shor, Peggy
- Subjects
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ANALYSIS of covariance , *ANALYSIS of variance , *ARM , *BIOMECHANICS , *STATISTICAL correlation , *FUNCTIONAL assessment , *DOSE-response relationship in biochemistry , *HEMIPLEGIA , *LIFE skills , *LONGITUDINAL method , *MEDICAL cooperation , *MEDICAL rehabilitation , *PSYCHOLOGY of movement , *OCCUPATIONAL therapy , *HEALTH outcome assessment , *PATIENTS , *PHYSICAL therapy , *PROBABILITY theory , *PSYCHOLOGICAL tests , *REGRESSION analysis , *REHABILITATION centers , *RESEARCH , *RESEARCH funding , *ROBOTICS , *SCALE analysis (Psychology) , *STATISTICS , *STROKE , *VETERANS' hospitals , *PRODUCT design , *DATA analysis , *ACTIVITIES of daily living , *BODY movement , *RANDOMIZED controlled trials , *TREATMENT effectiveness , *INTER-observer reliability , *RESEARCH methodology evaluation , *TREATMENT duration , *STROKE rehabilitation , *STROKE patients ,RESEARCH evaluation - Abstract
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. [ABSTRACT FROM AUTHOR]
- Published
- 2011
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