Unilateral versus bilateral robot-assisted rehabilitation on arm-trunk control and functions post stroke: a randomized controlled trial
Identifieur interne : 001723 ( Main/Exploration ); précédent : 001722; suivant : 001724Unilateral versus bilateral robot-assisted rehabilitation on arm-trunk control and functions post stroke: a randomized controlled trial
Auteurs : Ching-Yi Wu [Taïwan] ; Chieh-Ling Yang [Taïwan] ; Ming-De Chen [Taïwan] ; Keh-Chung Lin [Taïwan] ; Li-Ling Wu [Taïwan]Source :
- Journal of NeuroEngineering and Rehabilitation [ 1743-0003 ] ; 2013.
Abstract
Although the effects of robot-assisted arm training after stroke are promising, the relative effects of unilateral (URT) vs. bilateral (BRT) robot-assisted arm training remain uncertain. This study compared the effects of URT vs. BRT on upper extremity (UE) control, trunk compensation, and function in patients with chronic stroke.
This was a single-blinded, randomized controlled trial. The intervention was implemented at 4 hospitals. Fifty-three patients with stroke were randomly assigned to URT, BRT, or control treatment (CT). Each group received UE training for 90 to 105 min/day, 5 days/week, for 4 weeks. The kinematic variables for arm motor control and trunk compensation included normalized movement time, normalized movement units, and the arm-trunk contribution slope in unilateral and bilateral tasks. Motor function and daily function were measured by the Wolf Motor Function Test (WMFT), Motor Activity Log (MAL), and ABILHAND Questionnaire.
The BRT and CT groups elicited significantly larger slope values (i.e., less trunk compensation) at the start of bilateral reaching than the URT group. URT led to significantly better effects on WMFT-Time than BRT. Differences in arm control kinematics and performance on the MAL and ABILHAND among the 3 groups were not significant.
BRT and URT resulted in differential improvements in specific UE/trunk performance in patients with stroke. BRT elicited larger benefits than URT on reducing compensatory trunk movements at the beginning of reaching. In contrast, URT produced better improvements in UE temporal efficiency. These relative effects on movement kinematics, however, did not translate into differential benefits in daily functions.
ClinicalTrials.gov:
Url:
DOI: 10.1186/1743-0003-10-35
PubMed: 23587106
PubMed Central: 3640972
Affiliations:
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<author><name sortKey="Yang, Chieh Ling" sort="Yang, Chieh Ling" uniqKey="Yang C" first="Chieh-Ling" last="Yang">Chieh-Ling Yang</name>
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<author><name sortKey="Chen, Ming De" sort="Chen, Ming De" uniqKey="Chen M" first="Ming-De" last="Chen">Ming-De Chen</name>
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<front><div type="abstract" xml:lang="en"><sec><title>Background</title>
<p>Although the effects of robot-assisted arm training after stroke are promising, the relative effects of unilateral (URT) vs. bilateral (BRT) robot-assisted arm training remain uncertain. This study compared the effects of URT vs. BRT on upper extremity (UE) control, trunk compensation, and function in patients with chronic stroke.</p>
</sec>
<sec><title>Method</title>
<p>This was a single-blinded, randomized controlled trial. The intervention was implemented at 4 hospitals. Fifty-three patients with stroke were randomly assigned to URT, BRT, or control treatment (CT). Each group received UE training for 90 to 105 min/day, 5 days/week, for 4 weeks. The kinematic variables for arm motor control and trunk compensation included normalized movement time, normalized movement units, and the arm-trunk contribution slope in unilateral and bilateral tasks. Motor function and daily function were measured by the Wolf Motor Function Test (WMFT), Motor Activity Log (MAL), and ABILHAND Questionnaire.</p>
</sec>
<sec><title>Results</title>
<p>The BRT and CT groups elicited significantly larger slope values (i.e., less trunk compensation) at the start of bilateral reaching than the URT group. URT led to significantly better effects on WMFT-Time than BRT. Differences in arm control kinematics and performance on the MAL and ABILHAND among the 3 groups were not significant.</p>
</sec>
<sec><title>Conclusions</title>
<p>BRT and URT resulted in differential improvements in specific UE/trunk performance in patients with stroke. BRT elicited larger benefits than URT on reducing compensatory trunk movements at the beginning of reaching. In contrast, URT produced better improvements in UE temporal efficiency. These relative effects on movement kinematics, however, did not translate into differential benefits in daily functions.</p>
</sec>
<sec><title>Trial registration</title>
<p>ClinicalTrials.gov: <ext-link ext-link-type="uri" xlink:href="http://www.clinicaltrials.gov/show/NCT00917605">NCT00917605</ext-link>
.</p>
</sec>
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<affiliations><list><country><li>Taïwan</li>
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<tree><country name="Taïwan"><noRegion><name sortKey="Wu, Ching Yi" sort="Wu, Ching Yi" uniqKey="Wu C" first="Ching-Yi" last="Wu">Ching-Yi Wu</name>
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<name sortKey="Chen, Ming De" sort="Chen, Ming De" uniqKey="Chen M" first="Ming-De" last="Chen">Ming-De Chen</name>
<name sortKey="Lin, Keh Chung" sort="Lin, Keh Chung" uniqKey="Lin K" first="Keh-Chung" last="Lin">Keh-Chung Lin</name>
<name sortKey="Lin, Keh Chung" sort="Lin, Keh Chung" uniqKey="Lin K" first="Keh-Chung" last="Lin">Keh-Chung Lin</name>
<name sortKey="Wu, Ching Yi" sort="Wu, Ching Yi" uniqKey="Wu C" first="Ching-Yi" last="Wu">Ching-Yi Wu</name>
<name sortKey="Wu, Li Ling" sort="Wu, Li Ling" uniqKey="Wu L" first="Li-Ling" last="Wu">Li-Ling Wu</name>
<name sortKey="Yang, Chieh Ling" sort="Yang, Chieh Ling" uniqKey="Yang C" first="Chieh-Ling" last="Yang">Chieh-Ling Yang</name>
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