Importance: Effective treatment of the affected hand after stroke is crucial for improved functional independence and recovery. Objective: To determine the feasibility and clinical utility of an electromyography-triggered hand robot. Design: Single-group repeated-measures design. Participants completed training 3×/wk for 6 wk. Feasibility data included participant feedback, adverse events, and compliance rates. Upper extremity outcomes were collected at baseline, discharge, and 6-wk follow-up. Setting: Outpatient clinic. Participants: Twelve stroke survivors at least 6 mo poststroke living in the community. Intervention: Eighteen sessions of intensive robotic hand therapy over 6 wk. Each 60-min treatment session was personalized to match the participant’s ability. Outcomes and Measures: Arm Motor Ability Test (AMAT), Stroke Impact Scale Hand subscale (SIS–H), Stroke Upper Limb Capacity Scale (SULCS), Fugl-Meyer Assessment, Box and Block Test, and dynamometer. Results: All participants completed the training phase. Mild skin pinching or rubbing at dorsal proximal interphalangeal joint and proximal arm fatigue were the most common adverse events. Improvements in raw scores were achieved from baseline to discharge for all outcome measures, except the SULCS. Participants significantly improved from baseline to discharge on the AMAT and the SIS–H, and improvements were maintained at 6-wk follow-up. Conclusion and Relevance: Robotic hand training was feasible, safe, and well tolerated. Participants reported and demonstrated improvements in functional use of the affected arm. Thirty percent of participants achieved clinically significant improvements on the AMAT. We recommend further study of the device in a larger study using the AMAT as a primary outcome measure. What This Article Adds: It is feasible and safe to implement a robotic hand training protocol for people with moderate to severe arm impairment in an outpatient setting. Robotic training may provide a viable option for this group to actively participate in intensive training of the distal hand.
BackgroundEvaluation of muscle strength as performed routinely with a dynamometer may be limited by important factors such as pain during muscle contraction. Few studies have compared formal strength testing with ultrasound to measure muscle bulk in adults with knee osteoarthritis (OA).MethodsWe investigated the muscle bulk of lower limb muscles in adults with knee OA using quantitative ultrasound. We analyzed the relationship between patient reported function and the muscle bulk of hip adductors, hip abductors, knee extensors and ankle plantarflexors. We further correlated muscle bulk measures with joint torques calculated with a hand held dynamometer. We hypothesized that ultrasound muscle bulk would have high levels of interrater reliability and correlate more strongly with pain and function than strength measured by a dynamometer. 23 subjects with unilateral symptomatic knee OA completed baseline questionnaires including the Western Ontario and McMaster Universities Arthritis Index (WOMAC) and Lower Extremity Activity Scale. Joint torque was measured with a dynamometer and muscle bulk was assessed with ultrasound.ResultsHigher ultrasound measured muscle bulk was correlated with less pain in all muscle groups. When comparing muscle bulk and torque measures, ultrasound-measured muscle bulk of the quadriceps was more strongly correlated with measures of pain and function than quadriceps isometric strength measured with a dynamometer.ConclusionsUltrasound is a feasible method to assess muscle bulk of lower limb muscles in adults with knee OA, with high levels of interrater reliability, and correlates negatively with patient reported function. Compared with use of a hand held dynamometer to measure muscle function, ultrasound may be a superior modality.
Introduction: The use of technology in stroke rehabilitation is growing rapidly. Upper extremity robotic devices provide both therapeutic intervention as well as objective kinematic assessment to evaluate arm ability of individuals with stroke. The InMotion 2® is a shoulder/elbow robot widely used in the clinic and within stroke rehabilitation research. It has the capability to provide kinematic assessment of the arm, however there are no age-referenced normative values available for comparison to a healthy population. The aim of this study was to establish normative kinematic values for the InMotion 2 robot. Hypothesis: Not Applicable. Methods: Forty healthy individuals with no history of stroke or other neurological conditions with full passive and active range of motion in both upper extremities were recruited from the community. Subjects were recruited based on age (40-49, 50-59, 60-69, 70-80), 10 subjects per group (5 males and 5 females). Subjects were assessed on circle and clock drawing tasks with their dominant and non-dominant arm over three trials. The kinematic parameters measured included smoothness, joint independence, hold deviation, and displacement. The mean (M) and standard deviation (SD) of dominant hand test 1 and 2 were averaged together for combined scores across age groups. Results: The following age referenced normative values were determined for each kinematic parameter: smoothness (m/s), mean and SD for 40-49 age group (.585; .027), 50-59 (.566; .033), 60-69 (.540; .048), and 70-80 (.561; .033); joint independence: 40-49 (.861; .019), 50-59 (.858; .0394), 60-69 (.839; .030), and 70-80 (.853; 024); hold deviation (meters), 40-49 (.017; .005), 50-59 (.019; .004), 60-69 (.019; .006), and 70-80 (.022; .004); displacement (meters), 40-49 (.132; .001), 50-59 (.132; .001), 60-69 (.132; .001), and 70-80 (.131; .0004). Conclusion: The analysis demonstrated that age, sex, and hand dominance did not have a significant effect on normative kinematic outcomes, however age referenced normative values establish baseline and ceiling levels which provide more meaning when interpreting scores for individuals with stroke. Further research investigating the reliability of the kinematic parameters is currently underway.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.