Robot enhanced stroke therapy optimizes rehabilitation (RESTORE): a pilot study
Abstract Background Robotic rehabilitation after stroke provides the potential to increase and carefully control dosage of therapy. Only a small number of studies, however, have examined robotic therapy in the first few weeks post-stroke. In this study we designed robotic upper extremity therapy tas...
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doaj-123934be6c344bfd85608b0925d9e4612021-01-24T12:19:33ZengBMCJournal of NeuroEngineering and Rehabilitation1743-00032021-01-0118111610.1186/s12984-021-00804-8Robot enhanced stroke therapy optimizes rehabilitation (RESTORE): a pilot studyAlexa B. Keeling0Mark Piitz1Jennifer A. Semrau2Michael D. Hill3Stephen H. Scott4Sean P. Dukelow5Hotchkiss Brain Institute, University of CalgaryDepartment of Clinical Neurosciences, University of CalgaryHotchkiss Brain Institute, University of CalgaryHotchkiss Brain Institute, University of CalgaryDepartment of Biomedical and Molecular Sciences, Queen’s UniversityHotchkiss Brain Institute, University of CalgaryAbstract Background Robotic rehabilitation after stroke provides the potential to increase and carefully control dosage of therapy. Only a small number of studies, however, have examined robotic therapy in the first few weeks post-stroke. In this study we designed robotic upper extremity therapy tasks for the bilateral Kinarm Exoskeleton Lab and piloted them in individuals with subacute stroke. Pilot testing was focused mainly on the feasibility of implementing these new tasks, although we recorded a number of standardized outcome measures before and after training. Methods Our team developed 9 robotic therapy tasks to incorporate feedback, intensity, challenge, and subject engagement as well as addressing both unimanual and bimanual arm activities. Subacute stroke participants were assigned to a robotic therapy (N = 9) or control group (N = 10) in a matched-group manner. The robotic therapy group completed 1-h of robotic therapy per day for 10 days in addition to standard therapy. The control group participated only in standard of care therapy. Clinical and robotic assessments were completed prior to and following the intervention. Clinical assessments included the Fugl-Meyer Assessment of Upper Extremity (FMA UE), Action Research Arm Test (ARAT) and Functional Independence Measure (FIM). Robotic assessments of upper limb sensorimotor function included a Visually Guided Reaching task and an Arm Position Matching task, among others. Paired sample t-tests were used to compare initial and final robotic therapy scores as well as pre- and post-clinical and robotic assessments. Results Participants with subacute stroke (39.8 days post-stroke) completed the pilot study. Minimal adverse events occurred during the intervention and adding 1 h of robotic therapy was feasible. Clinical and robotic scores did not significantly differ between groups at baseline. Scores on the FMA UE, ARAT, FIM, and Visually Guided Reaching improved significantly in the robotic therapy group following completion of the robotic intervention. However, only FIM and Arm Position Match improved over the same time in the control group. Conclusions The Kinarm therapy tasks have the potential to improve outcomes in subacute stroke. Future studies are necessary to quantify the benefits of this robot-based therapy in a larger cohort. Trial registration: ClinicalTrials.gov, NCT04201613, Registered 17 December 2019—Retrospectively Registered, https://clinicaltrials.gov/ct2/show/NCT04201613 .https://doi.org/10.1186/s12984-021-00804-8Stroke rehabilitationRobotic rehabilitationRoboticsSubacute stroke |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Alexa B. Keeling Mark Piitz Jennifer A. Semrau Michael D. Hill Stephen H. Scott Sean P. Dukelow |
spellingShingle |
Alexa B. Keeling Mark Piitz Jennifer A. Semrau Michael D. Hill Stephen H. Scott Sean P. Dukelow Robot enhanced stroke therapy optimizes rehabilitation (RESTORE): a pilot study Journal of NeuroEngineering and Rehabilitation Stroke rehabilitation Robotic rehabilitation Robotics Subacute stroke |
author_facet |
Alexa B. Keeling Mark Piitz Jennifer A. Semrau Michael D. Hill Stephen H. Scott Sean P. Dukelow |
author_sort |
Alexa B. Keeling |
title |
Robot enhanced stroke therapy optimizes rehabilitation (RESTORE): a pilot study |
title_short |
Robot enhanced stroke therapy optimizes rehabilitation (RESTORE): a pilot study |
title_full |
Robot enhanced stroke therapy optimizes rehabilitation (RESTORE): a pilot study |
title_fullStr |
Robot enhanced stroke therapy optimizes rehabilitation (RESTORE): a pilot study |
title_full_unstemmed |
Robot enhanced stroke therapy optimizes rehabilitation (RESTORE): a pilot study |
title_sort |
robot enhanced stroke therapy optimizes rehabilitation (restore): a pilot study |
publisher |
BMC |
series |
Journal of NeuroEngineering and Rehabilitation |
issn |
1743-0003 |
publishDate |
2021-01-01 |
description |
Abstract Background Robotic rehabilitation after stroke provides the potential to increase and carefully control dosage of therapy. Only a small number of studies, however, have examined robotic therapy in the first few weeks post-stroke. In this study we designed robotic upper extremity therapy tasks for the bilateral Kinarm Exoskeleton Lab and piloted them in individuals with subacute stroke. Pilot testing was focused mainly on the feasibility of implementing these new tasks, although we recorded a number of standardized outcome measures before and after training. Methods Our team developed 9 robotic therapy tasks to incorporate feedback, intensity, challenge, and subject engagement as well as addressing both unimanual and bimanual arm activities. Subacute stroke participants were assigned to a robotic therapy (N = 9) or control group (N = 10) in a matched-group manner. The robotic therapy group completed 1-h of robotic therapy per day for 10 days in addition to standard therapy. The control group participated only in standard of care therapy. Clinical and robotic assessments were completed prior to and following the intervention. Clinical assessments included the Fugl-Meyer Assessment of Upper Extremity (FMA UE), Action Research Arm Test (ARAT) and Functional Independence Measure (FIM). Robotic assessments of upper limb sensorimotor function included a Visually Guided Reaching task and an Arm Position Matching task, among others. Paired sample t-tests were used to compare initial and final robotic therapy scores as well as pre- and post-clinical and robotic assessments. Results Participants with subacute stroke (39.8 days post-stroke) completed the pilot study. Minimal adverse events occurred during the intervention and adding 1 h of robotic therapy was feasible. Clinical and robotic scores did not significantly differ between groups at baseline. Scores on the FMA UE, ARAT, FIM, and Visually Guided Reaching improved significantly in the robotic therapy group following completion of the robotic intervention. However, only FIM and Arm Position Match improved over the same time in the control group. Conclusions The Kinarm therapy tasks have the potential to improve outcomes in subacute stroke. Future studies are necessary to quantify the benefits of this robot-based therapy in a larger cohort. Trial registration: ClinicalTrials.gov, NCT04201613, Registered 17 December 2019—Retrospectively Registered, https://clinicaltrials.gov/ct2/show/NCT04201613 . |
topic |
Stroke rehabilitation Robotic rehabilitation Robotics Subacute stroke |
url |
https://doi.org/10.1186/s12984-021-00804-8 |
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