Accelerometry measuring the outcome of robot-supported upper limb training in chronic stroke: a randomized controlled trial.

Ryanne J M Lemmens,Rob J E M Smeets,Richard P J Geers,Sanne A N T D Pulles,Yvonne J M Janssen-Potten,Wilbert G M Bakx,Henk A M Seelen,Annick A A Timmermans

doi:10.1371/journal.pone.0096414

Ryanne J M Lemmens, Rob J E M Smeets + Show 6 more

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https://doi.org/10.1371/journal.pone.0096414

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Abstract

PurposeThis study aims to assess the extent to which accelerometers can be used to determine the effect of robot-supported task-oriented arm-hand training, relative to task-oriented arm-hand training alone, on the actual amount of arm-hand use of chronic stroke patients in their home situation.MethodsThis single-blind randomized controlled trial included 16 chronic stroke patients, randomly allocated using blocked randomization (n = 2) to receive task-oriented robot-supported arm-hand training or task-oriented (unsupported) arm-hand training. Training lasted 8 weeks, 4 times/week, 2×30 min/day using the (T-)TOAT ((Technology-supported)-Task-Oriented-Arm-Training) method. The actual amount of arm-hand use, was assessed at baseline, after 8 weeks training and 6 months after training cessation. Duration of use and intensity of use of the affected arm-hand during unimanual and bimanual activities were calculated.ResultsDuration and intensity of use of the affected arm-hand did not change significantly during and after training, with or without robot-support (i.e. duration of use of unimanual use of the affected arm-hand: median difference of −0.17% in the robot-group and −0.08% in the control group between baseline and after training cessation; intensity of the affected arm-hand: median difference of 3.95% in the robot-group and 3.32% in the control group between baseline and after training cessation). No significant between-group differences were found.ConclusionsAccelerometer data did not show significant changes in actual amount of arm-hand use after task-oriented training, with or without robot-support. Next to the amount of use, discrimination between activities performed and information about quality of use of the affected arm-hand are essential to determine actual arm-hand performance.Trial RegistrationControlled-trials.com ISRCTN82787126

Highlights

Stroke is a leading cause of serious, long-term disability
Participants and study protocol In the current study, which is a sub-study of a larger single-blind randomized controlled trial called TEST-TRACS (TechnologySupported Task-oriented Training of Arm-hand function in persons with Chronic Stroke, ISRCTN 82787126) [22], 16 chronic stroke patients, who all received their rehabilitation treatment at Adelante Rehabilitation Centre (Hoensbroek, The Netherlands), agreed to participate
Sixteen chronic stroke patients were included between May 2009 and May 2011

Summary

Introduction

Stroke is a leading cause of serious, long-term disability. 67% of stroke patients perceive the non-use of their affected arm-hand as a major problem [1]. Loss of arm-hand function and, loss of arm-hand performance limits the execution of activities of daily living, leading to greater dependency, restricted social participation and decreased quality of life [2,3]. Patients receive rehabilitation to improve arm-hand function, and even in the chronic stage after stroke, arm-hand performance may further improve with training [4,5]. Robotsupported therapy is a rehabilitation method allowing patients to train their arm-hand with high intensity, a large amount of practice and minimal use of therapists’ time. Several studies concluded that robot-supported arm-hand training may be a valuable rehabilitation method [6,7,8,9,10]

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