Gains Across WHO Dimensions of Function After Robot-Based Therapy in Stroke Subjects.
Adult
Aged
Female
Humans
Longitudinal Studies
Male
Middle Aged
Outcome Assessment, Health Care
Paresis
/ etiology
Recovery of Function
/ physiology
Robotics
Severity of Illness Index
Stroke
/ complications
Stroke Rehabilitation
/ instrumentation
Therapy, Computer-Assisted
/ instrumentation
World Health Organization
clinical trials
outcomes research
recovery
rehabilitation
stroke
Journal
Neurorehabilitation and neural repair
ISSN: 1552-6844
Titre abrégé: Neurorehabil Neural Repair
Pays: United States
ID NLM: 100892086
Informations de publication
Date de publication:
12 2020
12 2020
Historique:
pubmed:
22
10
2020
medline:
6
10
2021
entrez:
21
10
2020
Statut:
ppublish
Résumé
Studies examining the effects of therapeutic interventions after stroke often focus on changes in loss of body function/structure (impairment). However, improvements in activities limitations and participation restriction are often higher patient priorities, and the relationship that these measures have with loss of body function/structure is unclear. This study measured gains across WHO International Classification of Function (ICF) dimensions and examined their interrelationships. Subjects were recruited 11 to 26 weeks after hemiparetic stroke. Over a 3-week period, subjects received 12 sessions of intensive robot-based therapy targeting the distal arm. Each subject was assessed at baseline and at 1 month after end of therapy. At baseline, subjects (n = 40) were 134.7 ± 32.4 (mean ± SD) days poststroke and had moderate-severe arm motor deficits (arm motor Fugl-Meyer score of 35.6 ± 14.4) that were stable. Subjects averaged 2579 thumb movements and 1298 wrist movements per treatment session. After robot therapy, there was significant improvement in measures of body function/structure (Fugl-Meyer score) and activity limitations (Action Research Arm Test, Barthel Index, and Stroke Impact Scale-Hand), but not participation restriction (Stroke Specific Quality of Life Scale). Furthermore, while the degree of improvement in loss of body function/structure was correlated with improvement in activity limitations, neither improvement in loss of body function/structure nor improvement in activity limitations was correlated with change in participation restriction. After a 3-week course of robotic therapy, there was improvement in body function/structure and activity limitations but no reduction in participation restriction.
Sections du résumé
BACKGROUND
Studies examining the effects of therapeutic interventions after stroke often focus on changes in loss of body function/structure (impairment). However, improvements in activities limitations and participation restriction are often higher patient priorities, and the relationship that these measures have with loss of body function/structure is unclear.
OBJECTIVE
This study measured gains across WHO International Classification of Function (ICF) dimensions and examined their interrelationships.
METHODS
Subjects were recruited 11 to 26 weeks after hemiparetic stroke. Over a 3-week period, subjects received 12 sessions of intensive robot-based therapy targeting the distal arm. Each subject was assessed at baseline and at 1 month after end of therapy.
RESULTS
At baseline, subjects (n = 40) were 134.7 ± 32.4 (mean ± SD) days poststroke and had moderate-severe arm motor deficits (arm motor Fugl-Meyer score of 35.6 ± 14.4) that were stable. Subjects averaged 2579 thumb movements and 1298 wrist movements per treatment session. After robot therapy, there was significant improvement in measures of body function/structure (Fugl-Meyer score) and activity limitations (Action Research Arm Test, Barthel Index, and Stroke Impact Scale-Hand), but not participation restriction (Stroke Specific Quality of Life Scale). Furthermore, while the degree of improvement in loss of body function/structure was correlated with improvement in activity limitations, neither improvement in loss of body function/structure nor improvement in activity limitations was correlated with change in participation restriction.
CONCLUSIONS
After a 3-week course of robotic therapy, there was improvement in body function/structure and activity limitations but no reduction in participation restriction.
Identifiants
pubmed: 33084499
doi: 10.1177/1545968320956648
pmc: PMC7704906
mid: NIHMS1621109
doi:
Types de publication
Clinical Trial
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
1150-1158Subventions
Organisme : NICHD NIH HHS
ID : K24 HD074722
Pays : United States
Organisme : NINDS NIH HHS
ID : R01 NS059909
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR001414
Pays : United States
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