STROKE — UPPER EXTREMITY REHABILITATION
Robot treated group had a 30% improvement in FIM® scores compared to the control group, Significant Impairment Reduction.
In a multi-center, randomized controlled trial involving 127 chronic stroke patients with moderate to severe upper-limb impairment, InMotion assist-as-needed™ therapy demonstrated significant improvement in arm movement, function and quality of life.
(Lo. A.C., et.al “Robot-Assisted Therapy for Long-Term Upper Limb Impairment after Stroke,” New England Journal of Medicine, 362:1772, May 13, 2010)
In a controlled clinical study involving 56 stroke inpatients, the motor skills of the robot-treated group improved significantly more than the control group. Analysis showed that interactive robotic therapy significantly reduced motor impairment of the treated limbs, doubling the impairment reduction.
(Volpe, B.T., Krebs, H.I., Hogan, N., Edelstein, O.L., Diels, C and Aisen, M., A Novel Approach to Stroke Rehabilitation Robot-Assisted Sensori-motor Stimulation, Neurology, 54 (2000) 1938-44)
Long Lasting Improvements
Patients from an early clinical study were recalled three years later, and those patients who received interactive robotic therapy sustained their improvement over those who did not. Moreover, subsequent follow-up studies re-examining these patients also confirmed the findings.
(Volpe, B.T., Krebs, H.I., Hogan, N., Edelstein, L., Diels, C.M. and Aisen, M.L. Robot Training Enhanced Motor Outcome in Patients with Stroke Maintained over 3 years, Neurology, 53 (1999) 1874-6)
(Volpe, B.T., Krebs, H.I., Hogan, N.; “Is Robot-Aided Sensorimotor Training in Stroke Rehabilitation a Realistic Opinion? Current Opinion in Neurology, Lippincott Williams &Wilkins, 14:745-752, 2001)
These trials are cited by the American Heart Association Stroke Rehabilitation Guidelines for recommending interactive robot assisted therapy in the inpatient , outpatient and chronic care settings
Improvement can Occur Even Several Years Post Onset of Injury
A multi-center VA study of 127 patients with long-term severe to moderate upper-limb impairment from a stroke that occurred at least 6 months before enrollment (average time of 4.7 years, 33% with multiple strokes) found that “the improvements… provide evidence of potential long-term benefits of rehabilitation and challenge the widely held clinical belief that gains in motor function are not possible for long term stroke survivors.”
(Lo, A.C., et al, “Robot-Assisted Therapy for Long-Term Upper-Limb Impairment after Stroke,”
New England Journal of Medicine, 362 1772, May 13, 2010)
Patients, who had suffered a single unilateral stroke one to five years earlier and who were demonstrated to be in a “stable phase,” showed significant improvement after receiving robotic therapy three times a week for six weeks. These findings also suggest that such patients have potential for further recovery which conventional therapy has been unable to tap into.
(Fasoli, S.D., Krebs, H.I., Stein, J., Frontera, W.R. and Hogan, N., “Effects of Robotic Therapy on Motor Impartment and Recovery in Chronic Stroke”, Archives of Physical Medicine and Rehabilitation; 84(2003)477-82)
(Fasoli, S. D., Krebs, H.I., Stein, J., Frontera, W.R. and Hogan, N., “Robotic Therapy for Chronic Motor Impairments are Stroke: Follow-up Results,” Achieves of Physical Medicine and Rehabilitation; 85 1106-111, 2004)
(Ferraro, M., Palazzolo, J. J. Krol, J. Krebs, H. I., Hogan, N., Volpe, B. T., “Robot Aided Sensorimotor Arm Training Improves Outcome in Patients with Chronic Stroke,” Neurology, 61: 1604-1607,2003.)