Grace J Kim1, Lisa Rivera2, Joel Stein3. 1. Department of Rehabilitation Medicine, NewYork-Presbyterian/Weill Cornell Medical Center, New York, NY. Electronic address: grk9006@nyp.org. 2. Department of Rehabilitation Medicine, NewYork-Presbyterian/Weill Cornell Medical Center, New York, NY. 3. Department of Rehabilitation Medicine, NewYork-Presbyterian/Weill Cornell Medical Center, New York, NY; Division of Rehabilitation Medicine, Weill Cornell Medical College, New York, NY; Department of Rehabilitation and Regenerative Medicine, Columbia University College of Physicians and Surgeons, New York, NY.
Abstract
OBJECTIVE: To investigate the feasibility of a combined clinic-home intervention using a robotic elbow brace and, secondarily, to collect preliminary data on the efficacy of this clinic-home intervention. DESIGN: Nonrandomized pre-/postinterventional study. SETTING: Outpatient clinic and participants' homes. PARTICIPANTS: Individuals at least 6 months after stroke (N=11; 5 women and 6 men; mean age, 51.7y; mean time since stroke, 7.6y; mean Fugl-Meyer Assessment of the Upper Extremity [FMA-UE] score, 22 of 66) were enrolled from the community. INTERVENTIONS: Participants received training in an outpatient clinic from an experienced occupational therapist to gain independence with use of the device (3-9 sessions) followed by a 6-week home program using the device at home. MAIN OUTCOME MEASURES: Five instruments were administered before and after the study intervention: Modified Ashworth Scale, Box and Blocks test, FMA-UE, Arm Motor Ability Test, and Motor Activity Log-Amount of Use and Motor Activity Log-How Well subscales (MAL-AOU, MAL-HW). RESULTS: Nine participants completed the study. Participants used the device on average 42.9min/d, 5.3d/wk. The FMA-UE (t=3.32; P=.01), MAL-AOU (t=4.40; P=.002), and MAL-HW (t=4.02; P=.004) scores showed statistically significant improvement from baseline to discharge; the MAL-AOU (t=2.61; P=.035) and MAL-HW (t=2.47; P=.043) scores were also significantly improved from baseline to 3-month follow-up. CONCLUSIONS: This combined clinic-home intervention was feasible and effective. Participants demonstrated improvements in arm impairment and self-reported use of the arm from baseline to discharge; they continued to report significant improvement in actual use of the arm at 3-month follow-up.
OBJECTIVE: To investigate the feasibility of a combined clinic-home intervention using a robotic elbow brace and, secondarily, to collect preliminary data on the efficacy of this clinic-home intervention. DESIGN: Nonrandomized pre-/postinterventional study. SETTING:Outpatient clinic and participants' homes. PARTICIPANTS: Individuals at least 6 months after stroke (N=11; 5 women and 6 men; mean age, 51.7y; mean time since stroke, 7.6y; mean Fugl-Meyer Assessment of the Upper Extremity [FMA-UE] score, 22 of 66) were enrolled from the community. INTERVENTIONS:Participants received training in an outpatient clinic from an experienced occupational therapist to gain independence with use of the device (3-9 sessions) followed by a 6-week home program using the device at home. MAIN OUTCOME MEASURES: Five instruments were administered before and after the study intervention: Modified Ashworth Scale, Box and Blocks test, FMA-UE, Arm Motor Ability Test, and Motor Activity Log-Amount of Use and Motor Activity Log-How Well subscales (MAL-AOU, MAL-HW). RESULTS: Nine participants completed the study. Participants used the device on average 42.9min/d, 5.3d/wk. The FMA-UE (t=3.32; P=.01), MAL-AOU (t=4.40; P=.002), and MAL-HW (t=4.02; P=.004) scores showed statistically significant improvement from baseline to discharge; the MAL-AOU (t=2.61; P=.035) and MAL-HW (t=2.47; P=.043) scores were also significantly improved from baseline to 3-month follow-up. CONCLUSIONS: This combined clinic-home intervention was feasible and effective. Participants demonstrated improvements in arm impairment and self-reported use of the arm from baseline to discharge; they continued to report significant improvement in actual use of the arm at 3-month follow-up.
Authors: Yu Chen; Kingsley Travis Abel; John T Janecek; Yunan Chen; Kai Zheng; Steven C Cramer Journal: Int J Med Inform Date: 2018-12-11 Impact factor: 4.046
Authors: Frieder Wittmann; Jeremia P Held; Olivier Lambercy; Michelle L Starkey; Armin Curt; Raphael Höver; Roger Gassert; Andreas R Luft; Roman R Gonzenbach Journal: J Neuroeng Rehabil Date: 2016-08-11 Impact factor: 4.262