Effects of Treatment Intensity in Upper Limb Robot-Assisted Therapy for Chronic Stroke

Hsieh, Yu‐Wei; Wu, Ching‐Yi; Liao, Wan-Wen; Lin, Keh‐chung; K, Wu; Lee, Chia-yi

doi:10.1177/1545968310394871

Cited by 94 publications

(92 citation statements)

References 55 publications

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“…704,705 Overall, robotic therapy appears to provide some benefit for upper extremity motor abilities and participation but is of uncertain utility compared with dose-matched conventional upper limb exercise therapies. [706][707][708][709][710][711][712][713] NMES can be used for those with minimal ability for volitional muscle activation. It may be beneficial for improving upper extremity activity if used in combination with taskspecific training, particularly when applied to the wrist and hand muscles.…”

Section: Iib Bmentioning

confidence: 99%

Guidelines for Adult Stroke Rehabilitation and Recovery

Winstein¹,

Stein²,

Arena

et al. 2016

Stroke

2,169

840

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e98Purpose-The aim of this guideline is to provide a synopsis of best clinical practices in the rehabilitative care of adults recovering from stroke. Methods-Writing group members were nominated by the committee chair on the basis of their previous work in relevant topic areas and were approved by the American Heart Association (AHA) Stroke Council's Scientific Statement Oversight Committee and the AHA's Manuscript Oversight Committee. The panel reviewed relevant articles on adults using computerized searches of the medical literature through 2014. The evidence is organized within the context of the AHA framework and is classified according to the joint AHA/American College of Cardiology and supplementary AHA methods of classifying the level of certainty and the class and level of evidence. The document underwent extensive AHA internal and external peer review, Stroke Council Leadership review, and Scientific Statements Oversight Committee review before consideration and approval by the AHA Science Advisory and Coordinating Committee. Results-Stroke rehabilitation requires a sustained and coordinated effort from a large team, including the patient and his or her goals, family and friends, other caregivers (eg, personal care attendants), physicians, nurses, physical and occupational therapists, speech-language pathologists, recreation therapists, psychologists, nutritionists, social workers, and others. Communication and coordination among these team members are paramount in maximizing the effectiveness

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Section: Iib Bmentioning

confidence: 99%

Guidelines for Adult Stroke Rehabilitation and Recovery

Winstein¹,

Stein²,

Arena

et al. 2016

Stroke

2,169

840

View full text Add to dashboard Cite

show abstract

“…Several groups are studying the function of treatment intensity in upper limb rehabilitation, the preliminary results (pilot study) of which have shown that higher intensity robotic treatment (assisted forearm and wrist movements) affects greater improvements in motor ability and functional performance in stroke patients [69]. Higher intensity of robotic rehabilitation in acute phase appears to induce more substantial improvements than lower intensity treatments at discharge, but this difference does not remain after 6 months [70].…”

Section: Lower and Upper Limbmentioning

confidence: 99%

The value of robotic systems in stroke rehabilitation

Masiero

Poli

Rosati

et al. 2014

Expert Review of Medical Devices

135

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In this paper, we discuss robot-mediated neurorehabilitation as a significant emerging field in clinical medicine. Stroke rehabilitation is advancing toward more integrated processes, using robotics to facilitate this integration. Rehabilitation approaches have tremendous value in reducing long-term impairments in stroke patients during hospitalization and after discharge, of which robotic systems are a new modality that can provide more effective rehabilitation. The function of robotics in rehabilitative interventions has been examined extensively, generating positive yet not completely satisfactory clinical results. This article presents state-of-the-art robotic systems and their prospective function in poststroke rehabilitation of the upper and lower limbs.

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“…Patients in the higher-intensity RT received twice the number of the repetitions per unit of time than patients in the lower-intensity RT group. 15 Before the RT training, 5 minutes of mobilization warm-up were provided. After the training, the patients received 15 to 20 minutes of functional activities practice to help them transfer the acquired motor ability to their performance of daily activities.…”

Section: Interventionsmentioning

confidence: 99%

Dose–Response Relationship of Robot-Assisted Stroke Motor Rehabilitation

Hsieh

Wu²,

Lin³

et al. 2012

Stroke

Self Cite

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Background and Purpose-The increasing availability of robot-assisted therapy (RT), which provides quantifiable, reproducible, interactive, and intensive practice, holds promise for stroke rehabilitation, but data on its dose-response relation are scanty. This study used 2 different intensities of RT to examine the treatment effects of RT and the effect on outcomes of the severity of initial motor deficits. Methods-Fifty-four patients with stroke were randomized to a 4-week intervention of higher-intensity RT, lower-intensity RT, or control treatment. The primary outcome, the Fugl-Meyer Assessment, was administered at baseline, midterm, and posttreatment. Secondary outcomes included the Medical Research Council scale, the Motor Activity Log, and the physical domains of the Stroke Impact Scale. Results-The higher-intensity RT group showed significantly greater improvements on the Fugl-Meyer Assessment than the lower-intensity RT and control treatment groups at midterm (Pϭ0.003 and Pϭ0.02) and at posttreatment (Pϭ0.04 and Pϭ0.02). Within-group gains on the secondary outcomes were significant, but the differences among the 3 groups did not reach significance. Recovery rates of the higher-intensity RT group were higher than those of the lower-intensity RT group, particularly on the Fugl-Meyer Assessment. Scatterplots with curve fitting showed that patients with moderate motor deficits gained more improvements than those with severe or mild deficits after the higherintensity RT. Conclusions-This study demonstrated the higher treatment intensity provided by RT was associated with better motor outcome for patients with stroke, which may shape further stroke rehabilitation. Clinical Trial Registration-URL: http://clinicaltrials.gov. Unique identifier: NCT00917605.

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Effects of Treatment Intensity in Upper Limb Robot-Assisted Therapy for Chronic Stroke

Cited by 94 publications

References 55 publications

Guidelines for Adult Stroke Rehabilitation and Recovery

Guidelines for Adult Stroke Rehabilitation and Recovery

The value of robotic systems in stroke rehabilitation

Dose–Response Relationship of Robot-Assisted Stroke Motor Rehabilitation

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