Effects of task-oriented robot training on arm function, activity, and quality of life in chronic stroke patients: a randomized controlled trial
Identifieur interne : 001254 ( Main/Merge ); précédent : 001253; suivant : 001255Effects of task-oriented robot training on arm function, activity, and quality of life in chronic stroke patients: a randomized controlled trial
Auteurs : Annick Aa Timmermans [Pays-Bas, Belgique] ; Ryanne Jm Lemmens [Pays-Bas] ; Maurice Monfrance [Pays-Bas] ; Richard Pj Geers [Pays-Bas] ; Wilbert Bakx [Pays-Bas] ; Rob Jem Smeets [Pays-Bas] ; Henk Am Seelen [Pays-Bas]Source :
- Journal of NeuroEngineering and Rehabilitation [ 1743-0003 ] ; 2014.
English descriptors
- KwdEn :
- MESH :
- instrumentation : Exercise Therapy.
- methods : Exercise Therapy, Robotics.
- physiology : Motor Activity.
- physiopathology : Arm.
- rehabilitation : Stroke.
- Female, Humans, Male, Middle Aged, Quality of Life, Recovery of Function, Single-Blind Method.
Abstract
Over fifty percent of stroke patients experience chronic arm hand performance problems, compromising independence in daily life activities and quality of life. Task-oriented training may improve arm hand performance after stroke, whereby augmented therapy may lead to a better treatment outcome. Technology-supported training holds opportunities for increasing training intensity. However, the effects of robot-supported task-oriented training with real life objects in stroke patients are not known to date. The aim of the present study was to investigate the effectiveness and added value of the Haptic Master robot combined with task-oriented arm hand training in chronic stroke patients.
In a single-blind randomized controlled trial, 22 chronic stroke patients were randomly allocated to receive either task-oriented robot-assisted arm-hand training (experimental group) or task-oriented non-robotic arm-hand training (control group). For training, the T-TOAT (Technology-supported Task-Oriented Arm Training) method was applied. Training was provided during 8 weeks, 4 times/week, 2× 30 min/day.
A significant improvement after training on the Action Research Arm Test (ARAT) was demonstrated in the experimental group (p = 0.008). Results were maintained until 6 months after cessation of the training. On the perceived performance measure (Motor Activity Log (MAL)), both, the experimental and control group improved significantly after training (control group p = 0.008; experimental group p = 0.013). The improvements on MAL in both groups were maintained until 6 months after cessation of the training. With regard to quality of life, only in the control group a significant improvement after training was found (EuroQol-5D p = 0.015, SF-36 physical p = 0.01). However, the improvement on SF-36 in the control group was not maintained (p = 0.012). No between-group differences could be demonstrated on any of the outcome measures.
Arm hand performance improved in chronic stroke patients, after eight weeks of task oriented training. The use of a Haptic Master robot in support of task-oriented arm training did not show additional value over the video-instructed task-oriented exercises in highly functional stroke patients.
Current Controlled Trials
Url:
DOI: 10.1186/1743-0003-11-45
PubMed: 24684808
PubMed Central: 3973831
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Department of Rehabilitation Medicine, Maastricht University, Maastricht, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Research School CAPHRI, Department of Rehabilitation Medicine, Maastricht University, Maastricht</wicri:regionArea><wicri:noRegion>Maastricht</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="I4">Department of Rehabilitation Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Rehabilitation Medicine, Maastricht University Medical Centre, Maastricht</wicri:regionArea><wicri:noRegion>Maastricht</wicri:noRegion></affiliation></author><author><name sortKey="Seelen, Henk Am" sort="Seelen, Henk Am" uniqKey="Seelen H" first="Henk Am" last="Seelen">Henk Am Seelen</name><affiliation wicri:level="1"><nlm:aff id="I1">Adelante, Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Adelante, Centre of Expertise in Rehabilitation and Audiology, Hoensbroek</wicri:regionArea><wicri:noRegion>Hoensbroek</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="I2">Research School CAPHRI, Department of Rehabilitation Medicine, Maastricht University, Maastricht, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Research School CAPHRI, Department of Rehabilitation Medicine, Maastricht University, Maastricht</wicri:regionArea><wicri:noRegion>Maastricht</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">24684808</idno><idno type="pmc">3973831</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3973831</idno><idno type="RBID">PMC:3973831</idno><idno type="doi">10.1186/1743-0003-11-45</idno><date when="2014">2014</date><idno 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id="I1">Adelante, Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Adelante, Centre of Expertise in Rehabilitation and Audiology, Hoensbroek</wicri:regionArea><wicri:noRegion>Hoensbroek</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="I2">Research School CAPHRI, Department of Rehabilitation Medicine, Maastricht University, Maastricht, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Research School CAPHRI, Department of Rehabilitation Medicine, Maastricht University, Maastricht</wicri:regionArea><wicri:noRegion>Maastricht</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="I5">Reval - Rehabilitation Research Institute, Biomed – Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, Belgium</nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea>Reval - Rehabilitation Research Institute, Biomed – Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University</wicri:regionArea><wicri:noRegion>Hasselt University</wicri:noRegion></affiliation></author><author><name sortKey="Lemmens, Ryanne Jm" sort="Lemmens, Ryanne Jm" uniqKey="Lemmens R" first="Ryanne Jm" last="Lemmens">Ryanne Jm Lemmens</name><affiliation wicri:level="1"><nlm:aff id="I1">Adelante, Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Adelante, Centre of Expertise in Rehabilitation and Audiology, Hoensbroek</wicri:regionArea><wicri:noRegion>Hoensbroek</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="I2">Research School CAPHRI, Department of Rehabilitation Medicine, Maastricht University, Maastricht, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Research School CAPHRI, Department of Rehabilitation Medicine, Maastricht University, Maastricht</wicri:regionArea><wicri:noRegion>Maastricht</wicri:noRegion></affiliation></author><author><name sortKey="Monfrance, Maurice" sort="Monfrance, Maurice" uniqKey="Monfrance M" first="Maurice" last="Monfrance">Maurice Monfrance</name><affiliation wicri:level="1"><nlm:aff id="I1">Adelante, Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Adelante, Centre of Expertise in Rehabilitation and Audiology, Hoensbroek</wicri:regionArea><wicri:noRegion>Hoensbroek</wicri:noRegion></affiliation></author><author><name sortKey="Geers, Richard Pj" sort="Geers, Richard Pj" uniqKey="Geers R" first="Richard Pj" last="Geers">Richard Pj Geers</name><affiliation wicri:level="1"><nlm:aff id="I1">Adelante, Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Adelante, Centre of Expertise in Rehabilitation and Audiology, Hoensbroek</wicri:regionArea><wicri:noRegion>Hoensbroek</wicri:noRegion></affiliation></author><author><name sortKey="Bakx, Wilbert" sort="Bakx, Wilbert" uniqKey="Bakx W" first="Wilbert" last="Bakx">Wilbert Bakx</name><affiliation wicri:level="1"><nlm:aff id="I2">Research School CAPHRI, Department of Rehabilitation Medicine, Maastricht University, Maastricht, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Research School CAPHRI, Department of Rehabilitation Medicine, Maastricht University, Maastricht</wicri:regionArea><wicri:noRegion>Maastricht</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="I3">Adelante Rehabilitation Centre, Hoensbroek, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Adelante Rehabilitation Centre, Hoensbroek</wicri:regionArea><wicri:noRegion>Hoensbroek</wicri:noRegion></affiliation></author><author><name sortKey="Smeets, Rob Jem" sort="Smeets, Rob Jem" uniqKey="Smeets R" first="Rob Jem" last="Smeets">Rob Jem Smeets</name><affiliation wicri:level="1"><nlm:aff id="I1">Adelante, Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Adelante, Centre of Expertise in Rehabilitation and Audiology, Hoensbroek</wicri:regionArea><wicri:noRegion>Hoensbroek</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="I2">Research School CAPHRI, Department of Rehabilitation Medicine, Maastricht University, Maastricht, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Research School CAPHRI, Department of Rehabilitation Medicine, Maastricht University, Maastricht</wicri:regionArea><wicri:noRegion>Maastricht</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="I4">Department of Rehabilitation Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Rehabilitation Medicine, Maastricht University Medical Centre, Maastricht</wicri:regionArea><wicri:noRegion>Maastricht</wicri:noRegion></affiliation></author><author><name sortKey="Seelen, Henk Am" sort="Seelen, Henk Am" uniqKey="Seelen H" first="Henk Am" last="Seelen">Henk Am Seelen</name><affiliation wicri:level="1"><nlm:aff id="I1">Adelante, Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Adelante, Centre of Expertise in Rehabilitation and Audiology, Hoensbroek</wicri:regionArea><wicri:noRegion>Hoensbroek</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="I2">Research School CAPHRI, Department of Rehabilitation Medicine, Maastricht University, Maastricht, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Research School CAPHRI, Department of Rehabilitation Medicine, Maastricht University, Maastricht</wicri:regionArea><wicri:noRegion>Maastricht</wicri:noRegion></affiliation></author></analytic><series><title level="j">Journal of NeuroEngineering and Rehabilitation</title><idno type="eISSN">1743-0003</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Arm (physiopathology)</term><term>Exercise Therapy (instrumentation)</term><term>Exercise Therapy (methods)</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Motor Activity (physiology)</term><term>Quality of Life</term><term>Recovery of Function</term><term>Robotics (methods)</term><term>Single-Blind Method</term><term>Stroke (rehabilitation)</term></keywords><keywords scheme="MESH" qualifier="instrumentation" xml:lang="en"><term>Exercise Therapy</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Exercise Therapy</term><term>Robotics</term></keywords><keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Motor Activity</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Arm</term></keywords><keywords scheme="MESH" qualifier="rehabilitation" xml:lang="en"><term>Stroke</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Quality of Life</term><term>Recovery of Function</term><term>Single-Blind Method</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>Over fifty percent of stroke patients experience chronic arm hand performance problems, compromising independence in daily life activities and quality of life. Task-oriented training may improve arm hand performance after stroke, whereby augmented therapy may lead to a better treatment outcome. Technology-supported training holds opportunities for increasing training intensity. However, the effects of robot-supported task-oriented training with real life objects in stroke patients are not known to date. The aim of the present study was to investigate the effectiveness and added value of the Haptic Master robot combined with task-oriented arm hand training in chronic stroke patients.</p></sec><sec><title>Methods</title><p>In a single-blind randomized controlled trial, 22 chronic stroke patients were randomly allocated to receive either task-oriented robot-assisted arm-hand training (experimental group) or task-oriented non-robotic arm-hand training (control group). For training, the T-TOAT (Technology-supported Task-Oriented Arm Training) method was applied. Training was provided during 8 weeks, 4 times/week, 2× 30 min/day.</p></sec><sec><title>Results</title><p>A significant improvement after training on the Action Research Arm Test (ARAT) was demonstrated in the experimental group (p = 0.008). Results were maintained until 6 months after cessation of the training. On the perceived performance measure (Motor Activity Log (MAL)), both, the experimental and control group improved significantly after training (control group p = 0.008; experimental group p = 0.013). The improvements on MAL in both groups were maintained until 6 months after cessation of the training. With regard to quality of life, only in the control group a significant improvement after training was found (EuroQol-5D p = 0.015, SF-36 physical p = 0.01). However, the improvement on SF-36 in the control group was not maintained (p = 0.012). No between-group differences could be demonstrated on any of the outcome measures.</p></sec><sec><title>Conclusion</title><p>Arm hand performance improved in chronic stroke patients, after eight weeks of task oriented training. The use of a Haptic Master robot in support of task-oriented arm training did not show additional value over the video-instructed task-oriented exercises in highly functional stroke patients.</p></sec><sec><title>Clinical trial registration information</title><p>Current Controlled Trials <ext-link ext-link-type="uri" xlink:href="http://www.controlled-trials.com/ISRCTN82787126">ISRCTN82787126</ext-link></p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Ali, M" uniqKey="Ali M">M Ali</name></author><author><name sortKey="Atula, S" uniqKey="Atula S">S Atula</name></author><author><name sortKey="Bath, Pm" uniqKey="Bath P">PM Bath</name></author><author><name sortKey="Grotta, J" uniqKey="Grotta J">J Grotta</name></author><author><name sortKey="Hacke, W" uniqKey="Hacke W">W Hacke</name></author><author><name sortKey="Lyden, P" uniqKey="Lyden P">P Lyden</name></author><author><name sortKey="Marler, Jr" uniqKey="Marler J">JR 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Seelen</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Riener, R" uniqKey="Riener R">R Riener</name></author><author><name sortKey="Nef, T" uniqKey="Nef T">T Nef</name></author><author><name sortKey="Colombo, G" uniqKey="Colombo G">G Colombo</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Dobkin, Bh" uniqKey="Dobkin B">BH Dobkin</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Van Asseldonk, Eh" uniqKey="Van Asseldonk E">EH van Asseldonk</name></author><author><name sortKey="Wessels, M" uniqKey="Wessels M">M Wessels</name></author><author><name sortKey="Stienen, Ah" uniqKey="Stienen A">AH Stienen</name></author><author><name sortKey="Van Der Helm, Fc" uniqKey="Van Der Helm F">FC van der Helm</name></author><author><name sortKey="Van Der Kooij, H" uniqKey="Van Der Kooij H">H van der Kooij</name></author></analytic></biblStruct></listBibl></div1></back></TEI></record>Pour manipuler 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