Effects of Arm Weight Support Training to Promote Recovery of Upper Limb Function for Subacute Patients after Stroke with Different Levels of Arm Impairments.

Irene H L Chan,Kenneth N K Fong,Apple Q L Wang,Hobby K Y Cheung,Dora Y L Chan,Pinky H Y Chau,Eddy K N Cheng,Kathy K Y Chow

doi:10.1155/2016/9346374

Irene H L Chan, Kenneth N K Fong + Show 6 more

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https://doi.org/10.1155/2016/9346374

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Abstract

Purpose. The goal of this study was to investigate the effects of arm weight support training using the ArmeoSpring for subacute patients after stroke with different levels of hemiplegic arm impairments. Methods. 48 inpatients with subacute stroke, stratified into 3 groups from mild to severe upper extremity impairment, were engaged in ArmeoSpring training for 45 minutes daily, 5 days per week for 3 weeks, in addition to conventional rehabilitation. Evaluations were conducted at three measurement occasions: immediately before training (T1); immediately after training (T2); and at a 3-week follow-up (T3) by a blind rater. Results. Shoulder flexion active range of motion, Upper Extremity Scores in the Fugl-Meyer Assessment (FMA), and Vertical Catch had the greatest differences in gain scores for patients between severe and moderate impairments, whereas FMA Hand Scores had significant differences in gain scores between moderate and mild impairments. There was no significant change in muscle tone or hand-path ratios between T1, T2, and T3 within the groups. Conclusion. Arm weight support training is beneficial for subacute stroke patients with moderate to severe arm impairments, especially to improve vertical control such as shoulder flexion, and there were no adverse effects in muscle tone.

Highlights

Robots are one of the major technological revolutions in the past decade in rehabilitation training approaches for arm recovery
Results of within-group comparisons showed that Group 3 had no significant difference among the three measurement occasions except the Upper Extremity Score and the Hand Score of the Fugl-Meyer Assessment (FMA), time score of Vertical Catch, percentage and time scores of Horizontal Catch, and Functional Independence Measure (FIM) (p = 0.000–0.009)
Groups 1 and 2 showed more proximal improvement than Group 3

Summary

Introduction

Robots are one of the major technological revolutions in the past decade in rehabilitation training approaches for arm recovery. Assistive paretic limb movement in a reliable, controllable, repeatable, quantifiable, and flexible way that makes it an ideal tool to evaluate kinematic and kinetic measurements, implement rehabilitation paradigms, and facilitate motor recovery from stroke and other neurological diseases [1]. The paretic limb is enclosed in an actuated robotic suit that conforms to the patient’s limb configuration. It can capture full specification of the limb configuration and the force applied and allows forces to be measured independently at each joint. This provides valuable ordinal data for data analysis and evaluation of patients. A criticism of actuated upper extremity robots is that they allow patients to move with robotic actuators apart from the patient’s effort and attention, which negatively affects their motor recovery [2]

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