Chung-Shan Hung1, Yu-Wei Hsieh2, Ching-Yi Wu3, Yi-Ting Lin4, Keh-Chung Lin5, Chia-Ling Chen6. 1. School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan, Republic of China(∗). 2. Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine and Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan, Republic of China(†). 3. Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine and Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan, Republic of China(‡). 4. Unique Potential Gene Education Center, New Taipei City, Taiwan, Republic of China(§). 5. School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan, Republic of China(¶); Division of Occupational Therapy, Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, F4, 17, Xu Zhou Road, Taipei, Taiwan, Republic of China(¶). Electronic address: kehchunglin@ntu.edu.tw. 6. Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan, Republic of China(#); Graduate Institute of Early Intervention, College of Medicine, Chang Gung University, Taoyuan, Taiwan, Republic of China(#).
Abstract
BACKGROUND:Robot-assisted therapy (RT) is a promising intervention for stroke rehabilitation. RT hybridized with therapist-mediated therapy (eg, RT plus task-specific or impairment-oriented training) may possibly yield functionally relevant improvements. A comparative study of the different combination regimens is needed. OBJECTIVE: To investigate the efficacy of RT combined with task-specific training or impairment-oriented training on motor function and quality of life in patients with chronic stroke. DESIGN: A single-blind, randomized comparative efficacy study. SETTING:Two medical centers in Taiwan. PARTICIPANTS: Twenty-one subjects with chronic stroke. INTERVENTIONS: Participants were recruited and randomized into 1 of 2 groups: (1) RT combined with task-specific (RTT) training (enrolled, n = 11; completed, n = 11) or (2) RT combined with impairment-oriented (RTI) training (enrolled, n = 10; completed, n = 9). Participants received 20 intervention sessions (90-100 min/d, 5 d/wk for 4 weeks). OUTCOMES: The Fugl-Meyer Motor Assessment Upper Extremity subscale, Stroke Impact Scale, Action Research Arm Test, and Medical Research Council Scale were administered at baseline, posttreatment, and at 3-month follow-up. Two-way repeated-measures analysis of variance was used to investigate the treatment effects. RESULTS: The improvements of the RTT group in motor function measured by the Fugl-Meyer Motor Assessment Upper Extremity subscale and quality of life assessed by the Stroke Impact Scale were significantly superior to the RTI group after the interventions. The improvements of the RTT group were maintained for 3 months. Both groups demonstrated significant within-group improvements in motor function, muscle power, and quality of life. CONCLUSIONS:RTT may be a more compelling approach to enhance motor function and quality of life for a long-term period than RTI. The combination of RT with task-specific training and with impairment-oriented training had similar benefits on upper limb motor function and muscle strength immediately after the interventions.
RCT Entities:
BACKGROUND: Robot-assisted therapy (RT) is a promising intervention for stroke rehabilitation. RT hybridized with therapist-mediated therapy (eg, RT plus task-specific or impairment-oriented training) may possibly yield functionally relevant improvements. A comparative study of the different combination regimens is needed. OBJECTIVE: To investigate the efficacy of RT combined with task-specific training or impairment-oriented training on motor function and quality of life in patients with chronic stroke. DESIGN: A single-blind, randomized comparative efficacy study. SETTING: Two medical centers in Taiwan. PARTICIPANTS: Twenty-one subjects with chronic stroke. INTERVENTIONS:Participants were recruited and randomized into 1 of 2 groups: (1) RT combined with task-specific (RTT) training (enrolled, n = 11; completed, n = 11) or (2) RT combined with impairment-oriented (RTI) training (enrolled, n = 10; completed, n = 9). Participants received 20 intervention sessions (90-100 min/d, 5 d/wk for 4 weeks). OUTCOMES: The Fugl-Meyer Motor Assessment Upper Extremity subscale, Stroke Impact Scale, Action Research Arm Test, and Medical Research Council Scale were administered at baseline, posttreatment, and at 3-month follow-up. Two-way repeated-measures analysis of variance was used to investigate the treatment effects. RESULTS: The improvements of the RTT group in motor function measured by the Fugl-Meyer Motor Assessment Upper Extremity subscale and quality of life assessed by the Stroke Impact Scale were significantly superior to the RTI group after the interventions. The improvements of the RTT group were maintained for 3 months. Both groups demonstrated significant within-group improvements in motor function, muscle power, and quality of life. CONCLUSIONS: RTT may be a more compelling approach to enhance motor function and quality of life for a long-term period than RTI. The combination of RT with task-specific training and with impairment-oriented training had similar benefits on upper limb motor function and muscle strength immediately after the interventions.
Authors: Justin B Rowe; Vicky Chan; Morgan L Ingemanson; Steven C Cramer; Eric T Wolbrecht; David J Reinkensmeyer Journal: Neurorehabil Neural Repair Date: 2017-08 Impact factor: 3.919
Authors: Helen Rodgers; Helen Bosomworth; Hermano I Krebs; Frederike van Wijck; Denise Howel; Nina Wilson; Tracy Finch; Natasha Alvarado; Laura Ternent; Cristina Fernandez-Garcia; Lydia Aird; Sreeman Andole; David L Cohen; Jesse Dawson; Gary A Ford; Richard Francis; Steven Hogg; Niall Hughes; Christopher I Price; Duncan L Turner; Luke Vale; Scott Wilkes; Lisa Shaw Journal: Health Technol Assess Date: 2020-10 Impact factor: 4.014