ArmAssist Robotic System versus Matched Conventional Therapy for Poststroke Upper Limb Rehabilitation: A Randomized Clinical Trial

Abstract

The ArmAssist is a simple low-cost robotic system for upper limb motor training that combines known benefits of repetitive task-oriented training, greater intensity of practice, and less dependence on therapist assistance. The aim of this preliminary study was to compare the efficacy of ArmAssist (AA) robotic training against matched conventional arm training in subacute stroke subjects with moderate-to-severe upper limb impairment. Twenty-six subjects were enrolled within 3 months of stroke and randomly assigned to the AA group or Control group (n = 13 each). Both groups were trained 5 days per week for 3 weeks. The primary outcome measure was Fugl-Meyer Assessment-Upper Extremity (FMA-UE) motor score, and the secondary outcomes were Wolf Motor Function Test-Functional Ability Scale (WMFT-FAS) and Barthel index (BI). The AA group, in comparison to the Control group, showed significantly greater increases in FMA-UE score (18.0 ± 9.4 versus 7.5 ± 5.5, p = 0.002) and WMFT-FAS score (14.1 ± 7.9 versus 6.7 ± 7.8, p = 0.025) after 3 weeks of treatment, whereas the increase in BI was not significant (21.2 ± 24.8 versus 13.1 ± 10.7, p = 0.292). There were no adverse events. We conclude that arm training using the AA robotic device is safe and able to reduce motor deficits more effectively than matched conventional arm training in subacute phase of stroke. The study has been registered at the ClinicalTrials.gov, ID: NCT02729649.

A Usability Study in Patients With Stroke Using MERLIN, a Robotic System Based on Serious Games for Upper Limb Rehabilitation in Home Setting

“…The AA system has been previously tested in clinical setting by therapists and patients with positive results on acceptance (11) and effectiveness with the improvements in the motor function of the patients after the use of it (24). Previous studies also demonstrated that the therapy using AA system is enjoyable and motivating because engages patients (27).…”

A serious game for virtual rehabilitation: evaluation with patients and physiotherapists

“…It is also considered one of the main causes of disabilities [15], resulting not only in persistent neurological deficits but also in upper limb dysfunction, which affects about 85% of stroke survivors, and less than half recover motor function within three months of poststroke. In addition, the level of recovery of the motor function has a great influence on the participation of people in community environments and on the quality of life [1].…”

“…Rehabilitation programs generally focus on tasks with a large number of repetitions, which is essential for promoting motor learning [16] and it is positively related to better motor recovery [1,17]. However, conventional treatments are not as frequent and intense as required because of the cost and of the commitment of patients in rehabilitation programs that eventually become repetitive.…”

“…Stroke is the leading cause of long-term disability in the world [1] and upper limb paresis is one of the most frequent and persistent impairments following stroke. Only 12-34% of stroke patients fully recover the upper limb functioning, which seems to be required to use the affected arm in daily tasks [2].…”

Dispositivo Robótico Multifuncional para la Rehabilitación de las Extremidades Superiores

“…Aún así, algunos autores han seguido investigando por esta linea, siendo muchos los robots serie de rehabilitación que se pueden encontrar en la bibliografía, como es el caso de los robots WAM (Whole Arm Manipulator) (Bai et al, 2017;Rainer Birkenbach et al, 2012), ATD (Active therapeutic device) (Westerveld et al, 2014) o Robotherapist (Furusho et al, 2007). Los avances de las propuestas han permitido realizar los primeros ensayos con pacientes con discapacidad motora comprobando los beneficios de terapias de neurorehabilitación a través de dispositivos robóticos (Tomić et al, 2017;Lledó et al, 2016).…”