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Intensive Sensorimotor Arm Training Mediated by Therapist or Robot Improves Hemiparesis in Patients With Chronic Stroke
Bruce T. Volpe, MD
Department of Neurology and Neuroscience, Burke Institute of Medical Research, Weill Medical College, Cornell University, White Plains, NY, Newman Laboratory, Mechanical Engineering Department, Massachusetts Institute of Technology, Cambridge, btv3{at}cornell.edu
Daniel Lynch, OT/L
Department of Neurology and Neuroscience, Burke Institute of Medical Research, Weill Medical College, Cornell University, White Plains, NY
Avrielle Rykman-Berland, OT/L
Department of Neurology and Neuroscience, Burke Institute of Medical Research, Weill Medical College, Cornell University, White Plains, NY
Mark Ferraro, OT/L
Department of Neurology and Neuroscience, Burke Institute of Medical Research, Weill Medical College, Cornell University, White Plains, NY
Michael Galgano
Department of Neurology and Neuroscience, Burke Institute of Medical Research, Weill Medical College, Cornell University, White Plains, NY
Neville Hogan, PhD
Newman Laboratory, Mechanical Engineering Department, Massachusetts Institute of Technology, Cambridge, Brain and Cognitive Sciences Department, Massachusetts Institute of Technology, Cambridge
Hermano I. Krebs, PhD
Department of Neurology and Neuroscience, Burke Institute of Medical Research, Weill Medical College, Cornell University, White Plains, NY, Newman Laboratory, Mechanical Engineering Department, Massachusetts Institute of Technology, Cambridge, Department of Neurology, University of Maryland Baltimore
Investigators have demonstrated that a variety of intensive movement training protocols for persistent upper limb paralysis in patients with chronic stroke (6 months or more after stroke) improve motor outcome. This randomized controlled study determined in patients with upper limb motor impairment after chronic stroke whether movement therapy delivered by a robot or by a therapist using an intensive training protocol was superior. Robotic training (n = 11) and an intensive movement protocol (n = 10) improved the impairment measures of motor outcome significantly and comparably; there were no significant changes in disability measures. Motor gains were maintained at the 3-month evaluation after training. These data contribute to the growing awareness that persistent impairments in those with chronic stroke may not reflect exhausted capacity for improvement. These new protocols, rendered by either therapist or robot, can be standardized, tested, and replicated, and potentially will contribute to rational activity-based programs.
Key Words: Stroke • Recovery of function • Rehabilitation.
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This version was published on June
1, 2008
Neurorehabilitation and Neural Repair, Vol. 22, No. 3,
305-310 (2008)
DOI: 10.1177/1545968307311102
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