Effects of Robot-assisted Arm Training in Patients with Subacute Stroke

Min Cheol Joo; Hyo In Park; See Eung Noh; Ji Hee Kim; Hyun Jun Kim; Chul Hwan Jang

doi:10.12786/bn.2014.7.2.111

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Joo, Park, Noh, Kim, Kim, and Jang: Effects of Robot-assisted Arm Training in Patients with Subacute Stroke

Original Article

Brain & Neurorehabilitation 2014; 7(2): 111-117.

Published online: 29 September 2014

DOI: https://doi.org/10.12786/bn.2014.7.2.111

Effects of Robot-assisted Arm Training in Patients with Subacute Stroke

Min Cheol Joo, M.D., Hyo In Park, M.D., See Eung Noh, M.D., Ji Hee Kim, M.D., Hyun Jun Kim, M.D., Chul Hwan Jang, M.D.

Department of Rehabilitation Medicine and Institute of Wonkwang Medical Science, Wonkwang University College of Medicine, Korea.

Correspondence to: Min Cheol Joo, Department of Rehabilitation Medicine and Institute of Wonkwang Medical Science, 895 Muwang-ro, Iksan 570-974, Korea. Tel: 063-859-1621, Fax: 063-843-1385, mcjoo68@wku.ac.kr

Received 13 February 2014 Revised 13 April 2014 Accepted 29 July 2014

Abstract

Objective

To investigate the effects of robot-assisted arm training on motor and functional recovery of upper limb in patients with subacute stroke.

Method

Thirty one subacute stroke patients were randomly divided into 2 groups. Robot-assisted arm training group received robot-assisted therapy using Armeo®Spring (Hocoma Inc., Zurich, Switzerland) for thirty minutes per day and five times every week during four weeks while control group received conventional arm training with same duration and frequency as robotic group. Outcome measures were used manual muscle test (MMT) for motor strength, Fugl-Meyer assessment (FMA), Manual function test (MFT) for arm function, Korean-modified Barthel index (K-MBI) for activities of daily living, Korean-mini mental state examination (K-MMSE) and Computerized Neuro-Cognitive Function test software-40 (CNT-40) for cognitive function. All recruited patients underwent these evaluations before and after four weeks robot-assisted arm training.

Results

Robot-assisted training on upper limb after subacute stroke showed improvement on motor strength, arm function, and activities of daily living. But change values in terms of MMT, FMA, MFT, K-MBI exhibited a no statistically significant difference compared with conventional group (p>0.05).

Conclusion

In patients with upper limb deficits after subacute stroke, Robot-assisted arm training was considered to facilitate motor and functional recovery of upper limb. But robot-assisted arm training did not significantly improve motor and arm function at 4 weeks compared with conventional arm training group. Further research is required about the comparison of conventional rehabilitation therapy group and the questions about the duration, severity of stroke.

Keywords: subacute stroke, robot, upper limb, rehabilitation

Figures and Tables

Fig. 1

Armeo®Spring robot.

Table 1

General Characteristics of the Subjects

Values are mean ± standard deviation. ^*Denotes significant difference between robot-assisted arm training and control group (p<0.05). MMT: Manual Muscle Test, FMA: Fugl-Meyer assessment, MFT: Motor Function Test, K-MBI: K-Modified Barthel Index, K-MMSE: K-mini mental status exam.

Table 2

Outcome of Robot-assisted Arm Training Group and Control Group

Values are median and quartiles of the dependent variables. ^*The p-values are for Mann Whitney U-tests as appropriate (^*p<0.05, ^**p<0.01). ^†Wilcoxon signed rank test. MMT: Manual Muscle Test, FMA: Fugl-Meyer assessment, MFT: Motor Function Test, K-MBI: K-Modified Barthel Index, K-MMSE: K-mini mental status exam.

Table 3

Clinical variables between Robot-assisted Arm Training Group and Control Group

Values are median and quartile of the change ratio: change ratio=(100^*the change d/t experiment)/baseline measurement. MMT: Manual Muscle Test, FMA: Fugl-Meyer assessment, MFT: Motor Function Test, K-MBI: K-Modified Barthel Index, K-MMSE: K-mini mental status exam.

Table 4

Comparisons of Changes in CNT-40 between Robot-assisted Arm Training Group and Control Group

Values are median and quartiles of the dependent variables. ^*Denotes significant difference in clinical parameters between pre and post treatment in both groups (^*p<0.05). MMT: Manual Muscle Test, FMA: Fugl-Meyer assessment, MFT: Motor Function Test, K-MBI: K-Modified Barthel Index, K-MMSE: K-mini mental status examination.

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