Results of Clinicians Using a Therapeutic Robotic System in an Inpatient Stroke Rehabilitation Unit
Identifieur interne : 002A23 ( Main/Merge ); précédent : 002A22; suivant : 002A24Results of Clinicians Using a Therapeutic Robotic System in an Inpatient Stroke Rehabilitation Unit
Auteurs : Hussein A. Abdullah [Canada] ; Cole Tarry [Canada] ; Cynthia Lambert [Canada] ; Susan Barreca [Canada] ; Brian O. Allen [Canada]Source :
- Journal of NeuroEngineering and Rehabilitation [ 1743-0003 ] ; 2011.
Abstract
Physical rehabilitation is an area where robotics could contribute significantly to improved motor return for individuals following a stroke. This paper presents the results of a preliminary randomized controlled trial (RCT) of a robot system used in the rehabilitation of the paretic arm following a stroke.
The study's objectives were to explore the efficacy of this new type of robotic therapy as compared to standard physiotherapy treatment in treating the post-stroke arm; to evaluate client satisfaction with the proposed robotic system; and to provide data for sample size calculations for a proposed larger multicenter RCT. Twenty clients admitted to an inpatient stroke rehabilitation unit were randomly allocated to one of two groups, an experimental (robotic arm therapy) group or a control group (conventional therapy). An occupational therapist blinded to patient allocation administered two reliable measures, the Chedoke Arm and Hand Activity Inventory (CAHAI-7) and the Chedoke McMaster Stroke Assessment of the Arm and Hand (CMSA) at admission and discharge. For both groups, at admission, the CMSA motor impairment stage of the affected arm was between 1 and 3.
Data were compared to determine the effectiveness of robot-assisted versus conventional therapy treatments. At the functional level, both groups performed well, with improvement in scores on the CAHAI-7 showing clinical and statistical significance. The CAHAI-7 (range7-49) is a measure of motor performance using functional items. Individuals in the robotic therapy group, on average, improved by 62% (95% CI: 26% to 107%) while those in the conventional therapy group changed by 30% (95% CI: 4% to 61%). Although performance on this measure is influenced by hand recovery, our results showed that both groups had similar stages of motor impairment in the hand. Furthermore, the degree of shoulder pain, as measured by the CMSA pain inventory scale, did not worsen for either group over the course of treatment.
Our findings indicated that robotic arm therapy alone, without additional physical therapy interventions tailored to the paretic arm, was as effective as standard physiotherapy treatment for all responses and more effective than conventional treatment for the CMSA Arm (p = 0.04) and Hand (p = 0.04). At the functional level, both groups performed equally well.
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DOI: 10.1186/1743-0003-8-50
PubMed: 21871095
PubMed Central: 3182973
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Results of Clinicians Using a Therapeutic Robotic System in an Inpatient Stroke Rehabilitation Unit</title><author><name sortKey="Abdullah, Hussein A" sort="Abdullah, Hussein A" uniqKey="Abdullah H" first="Hussein A" last="Abdullah">Hussein A. Abdullah</name><affiliation wicri:level="1"><nlm:aff id="I1">School of Engineering, University of Guelph, Guelph, N1G 2W1, Ontario, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>School of Engineering, University of Guelph, Guelph, N1G 2W1, Ontario</wicri:regionArea><wicri:noRegion>Ontario</wicri:noRegion></affiliation></author><author><name sortKey="Tarry, Cole" sort="Tarry, Cole" uniqKey="Tarry C" first="Cole" last="Tarry">Cole Tarry</name><affiliation wicri:level="1"><nlm:aff id="I1">School of Engineering, University of Guelph, Guelph, N1G 2W1, Ontario, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>School of Engineering, University of Guelph, Guelph, N1G 2W1, Ontario</wicri:regionArea><wicri:noRegion>Ontario</wicri:noRegion></affiliation></author><author><name sortKey="Lambert, Cynthia" sort="Lambert, Cynthia" uniqKey="Lambert C" first="Cynthia" last="Lambert">Cynthia Lambert</name><affiliation wicri:level="1"><nlm:aff id="I2">Hamilton Health Sciences, 237 Barton Street West, Hamilton, L8L 2 × 2, Ontario, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Hamilton Health Sciences, 237 Barton Street West, Hamilton, L8L 2 × 2, Ontario</wicri:regionArea><wicri:noRegion>Ontario</wicri:noRegion></affiliation></author><author><name sortKey="Barreca, Susan" sort="Barreca, Susan" uniqKey="Barreca S" first="Susan" last="Barreca">Susan Barreca</name><affiliation wicri:level="1"><nlm:aff id="I3">School of Rehabilitation Science, McMaster University, Hamilton, L8S 1C7, Ontario, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>School of Rehabilitation Science, McMaster University, Hamilton, L8S 1C7, Ontario</wicri:regionArea><wicri:noRegion>Ontario</wicri:noRegion></affiliation></author><author><name sortKey="Allen, Brian O" sort="Allen, Brian O" uniqKey="Allen B" first="Brian O" last="Allen">Brian O. Allen</name><affiliation wicri:level="1"><nlm:aff id="I4">Department of Mathematics and Statistics, University of Guelph, Guelph, N1G 2W1, Ontario, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Mathematics and Statistics, University of Guelph, Guelph, N1G 2W1, Ontario</wicri:regionArea><wicri:noRegion>Ontario</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">21871095</idno><idno type="pmc">3182973</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3182973</idno><idno type="RBID">PMC:3182973</idno><idno type="doi">10.1186/1743-0003-8-50</idno><date when="2011">2011</date><idno type="wicri:Area/Pmc/Corpus">002049</idno><idno type="wicri:Area/Pmc/Curation">002049</idno><idno type="wicri:Area/Pmc/Checkpoint">001A09</idno><idno type="wicri:Area/Ncbi/Merge">001B65</idno><idno type="wicri:Area/Ncbi/Curation">001B65</idno><idno type="wicri:Area/Ncbi/Checkpoint">001B65</idno><idno type="wicri:Area/Main/Merge">002A23</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Results of Clinicians Using a Therapeutic Robotic System in an Inpatient Stroke Rehabilitation Unit</title><author><name sortKey="Abdullah, Hussein A" sort="Abdullah, Hussein A" uniqKey="Abdullah H" first="Hussein A" last="Abdullah">Hussein A. Abdullah</name><affiliation wicri:level="1"><nlm:aff id="I1">School of Engineering, University of Guelph, Guelph, N1G 2W1, Ontario, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>School of Engineering, University of Guelph, Guelph, N1G 2W1, Ontario</wicri:regionArea><wicri:noRegion>Ontario</wicri:noRegion></affiliation></author><author><name sortKey="Tarry, Cole" sort="Tarry, Cole" uniqKey="Tarry C" first="Cole" last="Tarry">Cole Tarry</name><affiliation wicri:level="1"><nlm:aff id="I1">School of Engineering, University of Guelph, Guelph, N1G 2W1, Ontario, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>School of Engineering, University of Guelph, Guelph, N1G 2W1, Ontario</wicri:regionArea><wicri:noRegion>Ontario</wicri:noRegion></affiliation></author><author><name sortKey="Lambert, Cynthia" sort="Lambert, Cynthia" uniqKey="Lambert C" first="Cynthia" last="Lambert">Cynthia Lambert</name><affiliation wicri:level="1"><nlm:aff id="I2">Hamilton Health Sciences, 237 Barton Street West, Hamilton, L8L 2 × 2, Ontario, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Hamilton Health Sciences, 237 Barton Street West, Hamilton, L8L 2 × 2, Ontario</wicri:regionArea><wicri:noRegion>Ontario</wicri:noRegion></affiliation></author><author><name sortKey="Barreca, Susan" sort="Barreca, Susan" uniqKey="Barreca S" first="Susan" last="Barreca">Susan Barreca</name><affiliation wicri:level="1"><nlm:aff id="I3">School of Rehabilitation Science, McMaster University, Hamilton, L8S 1C7, Ontario, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>School of Rehabilitation Science, McMaster University, Hamilton, L8S 1C7, Ontario</wicri:regionArea><wicri:noRegion>Ontario</wicri:noRegion></affiliation></author><author><name sortKey="Allen, Brian O" sort="Allen, Brian O" uniqKey="Allen B" first="Brian O" last="Allen">Brian O. Allen</name><affiliation wicri:level="1"><nlm:aff id="I4">Department of Mathematics and Statistics, University of Guelph, Guelph, N1G 2W1, Ontario, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Mathematics and Statistics, University of Guelph, Guelph, N1G 2W1, Ontario</wicri:regionArea><wicri:noRegion>Ontario</wicri:noRegion></affiliation></author></analytic><series><title level="j">Journal of NeuroEngineering and Rehabilitation</title><idno type="eISSN">1743-0003</idno><imprint><date when="2011">2011</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>Physical rehabilitation is an area where robotics could contribute significantly to improved motor return for individuals following a stroke. This paper presents the results of a preliminary randomized controlled trial (RCT) of a robot system used in the rehabilitation of the paretic arm following a stroke.</p></sec><sec><title>Methods</title><p>The study's objectives were to explore the efficacy of this new type of robotic therapy as compared to standard physiotherapy treatment in treating the post-stroke arm; to evaluate client satisfaction with the proposed robotic system; and to provide data for sample size calculations for a proposed larger multicenter RCT. Twenty clients admitted to an inpatient stroke rehabilitation unit were randomly allocated to one of two groups, an experimental (robotic arm therapy) group or a control group (conventional therapy). An occupational therapist blinded to patient allocation administered two reliable measures, the Chedoke Arm and Hand Activity Inventory (CAHAI-7) and the Chedoke McMaster Stroke Assessment of the Arm and Hand (CMSA) at admission and discharge. For both groups, at admission, the CMSA motor impairment stage of the affected arm was between 1 and 3.</p></sec><sec><title>Results</title><p>Data were compared to determine the effectiveness of robot-assisted versus conventional therapy treatments. At the functional level, both groups performed well, with improvement in scores on the CAHAI-7 showing clinical and statistical significance. The CAHAI-7 (range7-49) is a measure of motor performance using functional items. Individuals in the robotic therapy group, on average, improved by 62% (95% CI: 26% to 107%) while those in the conventional therapy group changed by 30% (95% CI: 4% to 61%). Although performance on this measure is influenced by hand recovery, our results showed that both groups had similar stages of motor impairment in the hand. Furthermore, the degree of shoulder pain, as measured by the CMSA pain inventory scale, did not worsen for either group over the course of treatment.</p></sec><sec><title>Conclusion</title><p>Our findings indicated that robotic arm therapy alone, without additional physical therapy interventions tailored to the paretic arm, was as effective as standard physiotherapy treatment for all responses and more effective than conventional treatment for the CMSA Arm (p = 0.04) and Hand (p = 0.04). 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Stratford</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Barreca, B" uniqKey="Barreca B">B Barreca</name></author><author><name sortKey="Stratford, P" uniqKey="Stratford P">P Stratford</name></author><author><name sortKey="Lambert, C" uniqKey="Lambert C">C Lambert</name></author><author><name sortKey="Masters, L" uniqKey="Masters L">L Masters</name></author><author><name sortKey="Streiner, D" uniqKey="Streiner D">D Streiner</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Barreca, S" uniqKey="Barreca S">S Barreca</name></author><author><name sortKey="Stratford, P" uniqKey="Stratford P">P Stratford</name></author><author><name sortKey="Masters, L" uniqKey="Masters L">L Masters</name></author><author><name sortKey="Lambert, C" uniqKey="Lambert C">C Lambert</name></author><author><name sortKey="Griffiths, J" uniqKey="Griffiths J">J Griffiths</name></author><author><name sortKey="Mcbay, C" uniqKey="Mcbay C">C McBay</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Barreca, S" uniqKey="Barreca S">S Barreca</name></author><author><name sortKey="Stratford, P" uniqKey="Stratford P">P Stratford</name></author><author><name sortKey="Masters, L" uniqKey="Masters L">L Masters</name></author><author><name sortKey="Lambert, C" uniqKey="Lambert C">C Lambert</name></author><author><name sortKey="Griffiths, J" uniqKey="Griffiths J">J Griffiths</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Gowland, C" uniqKey="Gowland C">C Gowland</name></author><author><name sortKey="Stratford, P" uniqKey="Stratford P">P Stratford</name></author><author><name sortKey="Ward, M" uniqKey="Ward M">M Ward</name></author><author><name sortKey="Moreland, J" uniqKey="Moreland J">J Moreland</name></author><author><name sortKey="Torresin, W" uniqKey="Torresin W">W Torresin</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Snedecor, G" uniqKey="Snedecor G">G Snedecor</name></author><author><name sortKey="Cochran, W" uniqKey="Cochran W">W Cochran</name></author></analytic></biblStruct></listBibl></div1></back></TEI></record>Pour manipuler ce document sous Unix (Dilib)
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