New England Journal of Medicine— Robot-Assisted Therapy for Long-Term Upper-Limb Impairment after Stroke
Albert C. Lo, M.D., Ph.D., Peter D. Guarino, M.P.H., Ph.D., Lorie G. Richards, Ph.D., Jodie K. Haselkorn, M.D., M.P.H., George F. Wittenberg, M.D., Ph.D., Daniel G. Federman, M.D., Robert J. Ringer, Pharm.D., Todd H. Wagner, Ph.D., Hermano I. Krebs, Ph.D., Bruce T. Volpe, M.D., Christopher T. Bever, Jr., M.D., M.B.A., Dawn M. Bravata, M.D., Pamela W. Duncan, Ph.D., Barbara H. Corn, Ph.D., Alysia D. Maffucci, J.D., Stephen E. Nadeau, M.D., Susan S. Conroy, D.Sc., P.T., Janet M. Powell, Ph.D., Grant D. Huang, Ph.D., and Peter Peduzzi, Ph.D.
N Engl J Med 2010; 362:1772-1783May 13, 2010DOI: 10.1056/NEJMoa0911341
Stroke is a leading cause of long-term disability in the United States, affecting an estimated 6.4 million Americans.1 Long-term disability is often associated with persistent impairment of an upper limb.2Despite the development of many programs for recovery after stroke, the effectiveness of rehabilitation in improving functioning and quality of life for patients with deficits more than 6 months after a stroke has not been definitively shown. Robotic rehabilitation devices have the potential to deliver high-intensity, reproducible therapy. Advances in robotics and an increased understanding of the latent neurologic potential for stroke recovery led to our initiation of this multicenter, randomized, controlled trial, called the Veterans Affairs (VA) Robotic-Assisted Upper-Limb Neurorehabilitation in Stroke Patients study, to determine whether a rehabilitation protocol using the MIT–Manus robotic system (Interactive Motion Technologies),3 as compared with a program based on conventional rehabilitative techniques or usual care, could improve functioning and quality of life of stroke survivors with long-term upper-limb deficits. Read more