Robot-Assisted Therapy for Long-Term Upper-Limb Impairment after Stroke
By A. Lo, P. Guarino, L. Richards, J. Haselkorn, G. Wittenberg, D. Federman, R. Ringer, T. Wagner, H. Krebs, B. Volpe and 10 more. New England Journal of Medicine, 2010
1,343 citations recorded by the source corpus.
Background Effective rehabilitative therapies are needed for patients with long-term deficits after stroke. Methods In this multicenter, randomized, controlled trial involving 127 patients with moderate-to-severe upper-limb impairment 6 months or more after a stroke, we randomly assigned 49 patients to receive intensive robot-assisted therapy, 50 to receive intensive comparison therapy, and 28 to receive usual care. Therapy consisted of 36 1-hour sessions over a period of 12 weeks. The primary outcome was a change in motor function, as measured on the Fugl-Meyer Assessment of Sensorimotor Recovery after Stroke, at 12 weeks. Secondary outcomes were scores on the Wolf Motor Function Test and the Stroke Impact Scale. Secondary analyses assessed the treatment effect at 36 weeks. Results At 12 weeks, the mean Fugl-Meyer score for patients receiving robot-assisted therapy was better than that for patients receiving usual care (difference, 2.17 points; 95% confidence interval [CI], −0.23 to 4.58) and worse than that for patients receiving intensive comparison therapy (difference, −0.14 points; 95% CI, −2.94 to 2.65), but the differences were not significant. The results on the Stroke Impact Scale were significantly better for patients receiving robot-assisted therapy than for those receiving usual care (difference, 7.64 points; 95% CI, 2.03 to 13.24). No other treatment comparisons were significant at 12 weeks. Secondary analyses showed that at 36 weeks, robot-assisted therapy significantly improved the Fugl-Meyer score (difference, 2.88 points; 95% CI, 0.57 to 5.18) and the time on the Wolf Motor Function Test (difference, −8.10 seconds; 95% CI, −13.61 to −2.60) as compared with usual care but not with intensive therapy. No serious adverse events were reported. Conclusions In patients with long-term upper-limb deficits after stroke, robot-assisted therapy did not significantly improve motor function at 12 weeks, as compared with usual care or intensive therapy. In secondary analyses, robot-assisted therapy improved outcomes over 36 weeks as compared with usual care but not with intensive therapy. (ClinicalTrials.gov number, NCT00372411.)
Subfields: Epidemiology, Neurology, Rehabilitation
View Paper: https://www.semanticscholar.org/paper/7e3027a244856e70cf1058479881607fab939a89
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Citations in the corpus
- The Promise of mHealth: Daily Activity Monitoring and Outcome Assessments by Wearable Sensors (2011, background): “The WMFT and complementary ordinal scales are the de facto outcomes for most robotic, functional neuromuscular stimulation, and neurostimulation trials as well.(76-84) Interpretation of the WMFT improves when combined with a structured interview, such as the Motor Activity Log, about the amount of”
- Augmented visual, auditory, haptic, and multimodal feedback in motor learning: A review (2012, result): “…results are controversial: Some studies reported that patients profit more from conventional therapy than from robot-aided therapy (Hidler et al., 2009; Hornby et al., 2008), whereas others reported the opposite (Husemann, Muller, Krewer, Heller, & Koenig, 2007; Lo et al., 2010; Mayr et al., 2007).”
- Harnessing neuroplasticity for clinical applications (2011, neutral): “…treadmill training (Dobkin et al., 2006; Duncan et al., 2007), robotic devices (Volpe et al., 2008; Hidler et al., 2009; Housman et al., 2009; Lo et al., 2010), behavioural shaping, bilateral arm training (Lin et al., 2010) and task-oriented physical therapy (Jonsdottir et al., 2010) are all…”
- A Review of Intent Detection, Arbitration, and Communication Aspects of Shared Control for Physical Human-Robot Interaction (2018, background): “Indeed, a 127 person clinical trial conducted over a 6 month period found that there was no significant difference in the improvements of motor function for stroke subjects trained by robots as compared to those receiving traditional human-mediated therapy [154].”