Sofia Straudi1, Andrea Baroni2, Sonia Mele3, Laila Craighero3, Fabio Manfredini4, Nicola Lamberti4, Elisa Maietti5, Nino Basaglia4. 1. Neuroscience and Rehabilitation Department, Ferrara University Hospital, Ferrara, Italy. Electronic address: s.straudi@ospfe.it. 2. Neuroscience and Rehabilitation Department, Ferrara University Hospital, Ferrara, Italy; Doctoral Program in Translational Neurosciences and Neurotechnologies, Ferrara University, Ferrara, Italy. 3. Biomedical and Specialty Surgical Sciences Department, Ferrara University, Ferrara, Italy. 4. Neuroscience and Rehabilitation Department, Ferrara University Hospital, Ferrara, Italy; Biomedical and Specialty Surgical Sciences Department, Ferrara University, Ferrara, Italy. 5. Medical Science Department, Center for Clinical Epidemiology, Ferrara University, Ferrara, Italy; Department of Biomedical and Neuromotor Sciences, Bologna University, Bologna, Italy.
Abstract
OBJECTIVE: To compare the effects of unilateral, proximal arm robot-assisted therapy combined with hand functional electrical stimulation with intensive conventional therapy for restoring arm function in survivors of subacute stroke. DESIGN: This was a single-blinded, randomized controlled trial. SETTING:Inpatient rehabilitation university hospital. PARTICIPANTS: Patients (N=40) diagnosed as having ischemic stroke (time since stroke <8wk) and upper limb impairment were enrolled. INTERVENTIONS: Participants randomized to the experimental group received 30 sessions (5 sessions/wk) of robot-assisted arm therapy and hand functional electrical stimulation (RAT+FES). Participants randomized to the control group received a time-matched intensive conventional therapy. MAIN OUTCOME MEASURES: The primary outcome was arm motor recovery measured with the Fugl-Meyer Motor Assessment. Secondary outcomes included motor function, arm spasticity, and activities of daily living. Measurements were performed at baseline, after 3 weeks, at the end of treatment, and at 6-month follow-up. Presence of motor evoked potentials (MEPs) was also measured at baseline. RESULTS: Both groups significantly improved all outcome measures except for spasticity without differences between groups. Patients with moderate impairment and presence of MEPs who underwent early rehabilitation (<30d post stroke) demonstrated the greatest clinical improvements. CONCLUSIONS:RAT+FES was no more effective than intensive conventional arm training. However, at the same level of arm impairment and corticospinal tract integrity, it induced a higher level of arm recovery.
RCT Entities:
OBJECTIVE: To compare the effects of unilateral, proximal arm robot-assisted therapy combined with hand functional electrical stimulation with intensive conventional therapy for restoring arm function in survivors of subacute stroke. DESIGN: This was a single-blinded, randomized controlled trial. SETTING: Inpatient rehabilitation university hospital. PARTICIPANTS: Patients (N=40) diagnosed as having ischemic stroke (time since stroke <8wk) and upper limb impairment were enrolled. INTERVENTIONS:Participants randomized to the experimental group received 30 sessions (5 sessions/wk) of robot-assisted arm therapy and hand functional electrical stimulation (RAT+FES). Participants randomized to the control group received a time-matched intensive conventional therapy. MAIN OUTCOME MEASURES: The primary outcome was arm motor recovery measured with the Fugl-Meyer Motor Assessment. Secondary outcomes included motor function, arm spasticity, and activities of daily living. Measurements were performed at baseline, after 3 weeks, at the end of treatment, and at 6-month follow-up. Presence of motor evoked potentials (MEPs) was also measured at baseline. RESULTS: Both groups significantly improved all outcome measures except for spasticity without differences between groups. Patients with moderate impairment and presence of MEPs who underwent early rehabilitation (<30d post stroke) demonstrated the greatest clinical improvements. CONCLUSIONS:RAT+FES was no more effective than intensive conventional arm training. However, at the same level of arm impairment and corticospinal tract integrity, it induced a higher level of arm recovery.
Authors: Nicola Lamberti; Fabio Manfredini; Francesca Nardi; Andrea Baroni; Giovanni Piva; Anna Crepaldi; Nino Basaglia; Ilaria Casetta; Sofia Straudi Journal: Neurol Int Date: 2022-03-23
Authors: Timothy F Boerger; Allison S Hyngstrom; Julio C Furlan; Sukhvinder Kalsi-Ryan; Armin Curt; Brian K Kwon; Shekar N Kurpad; Michael G Fehlings; James S Harrop; Bizhan Aarabi; Vafa Rahimi-Movaghar; James D Guest; Jefferson R Wilson; Benjamin M Davies; Mark R N Kotter; Paul A Koljonen Journal: Global Spine J Date: 2022-02