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Upper Limb Robot Assisted Therapy in Rehabilitation of Acute Stroke Patients Focused Review and Results of New Randomized Controlled Trial

By Masiero, Stefano; Armani, Mario; Rosati, Giulio; Journal of Rehabilitation Research and Development, Vol. 48, No. 4, pp. 355-366
Publication Date: 2011

Randomized controlled trial tested the effectiveness of robotic training of the upper limb for patients with hemiparetic stroke in the subacute phase. The study employed the Neuro-Rehabilitation-roBot (NeReBot), a 3 degrees of freedom (DOF) robotic device for upper limbs that can be easily used in the acute phase thanks to its portability and usability at bedside. The robot is based on direct-drive wire actuation, using three actuated nylon cables to sustain and move the patient’s forearm, which is fastened onto a rigid splint. Participants were 21 patients with subacute hemiparetic stroke with a mean age of 74 years, 5 of whom were women. Participants were divided into an 11 member experimental group (EG) and a 10 member control group (CG). Both groups received treatment for 120 minutes, 5 days a week for 5 weeks. CG patients performed conventional functional rehabilitation for 80 minutes per day but without specifically exercising the proximal paretic arm, which was exercised during a separate 40 minute session. For the EG, conventional treatment of the proximal paretic arm was substituted with NeReBot training for 40 minutes a day. Assessments included a number of clinical evaluations at baseline, immediately post treatment, and at 3 month follow up. EG patients achieved similar reductions in motor impairment and enhancements in paretic upper limb function to those gained in the CG. Based on study results, a new robotic protocol for acute and subacute stroke patients based on both treatment modalities, in addition and in substitution, is hypothesized.
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VA Rehabilitation Research & Development Service    (Web Site: http://www.rehab.research.va.gov )
Link to text: http://www.rehab.research.va.gov/jour/11/484/page355.html
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