Abstract
Background: Stroke is one of the leading causes of adult disability, and up to 80% of stroke survivors undergo upper extremity motor dysfunction. Constraint-Induced Movement Therapy (CIMT) and Robot-Assisted Therapy (RT) are used for upper limb stroke rehabilitation. Although CIMT and RT are different techniques, both are beneficial; however, their results must be compared. The objective is to establish the difference between RT and CIMT after a rehabilitation program for chronic stroke patients.Method: This is a randomized clinical trial, registered at ClinicalTrials.gov (ID number NCT02700061), in which patients with stroke received sessions of RT or CIMT protocol, combined with a conventional rehabilitation program for 12 weeks. The primary outcome was measured by Wolf Motor Function Test (WMFT) and Fugl-Meyer Assessment—Upper Limb (FMA-UL). Activities of daily living were also assessed.Results: Fifty one patients with mild to moderate upper limb impairment were enrolled in this trial, 25 women and 26 men, mean age of 60,02 years old (SD 14,48), with 6 to 36 months after stroke onset. Function significantly improved regardless of the treatment group. However, no statistical difference was found between both groups as p-values of the median change of function measured by WMFT and FMA were 0.293 and 0.187, respectively.Conclusion: This study showed that Robotic Therapy (RT) was not different from Constraint-Induced Movement Therapy (CIMT) regardless of the analyzed variables. There was an overall upper limb function, motor recovery, functionality, and activities of daily living improvement regardless of the interventions. At last, the combination of both techniques should be considered in future studies.
Highlights
Stroke is one of the leading causes of disability worldwide
Robot-Assisted Therapy (RT) is based on the concept of high intensity and an increased number of repetitions of functional movements to induce upper limb functional improvement (Krebs and Hogan, 2006; Dipietro et al, 2012) and has been reported as a potential approach to provide stroke patients with motor and functional recovery of upper limbs, presenting promising results in the literature (Ferraro et al, 2003; Hesse et al, 2003; Dipietro et al, 2005; Krebs and Hogan, 2006; Krebs et al, 2008; Volpe et al, 2008; Lo et al, 2010)
Robotic devices provide stroke patients with intensive stimuli and allow the professionals to control the parameters during the rehabilitation session (Ferraro et al, 2003; Hesse et al, 2003; Dipietro et al, 2005; Krebs and Hogan, 2006; Krebs et al, 2008; Volpe et al, 2008; Lo et al, 2010)
Summary
Stroke is one of the leading causes of disability worldwide. Up to 80% of stroke survivors will endure upper limb motor dysfunction with reduced ability to perform daily living activities, an important issue of public health (Nichols-Larsen et al, 2005; Levin et al, 2009; Langhorne et al, 2011; Johnson et al, 2016). Robotic devices provide stroke patients with intensive stimuli and allow the professionals to control the parameters during the rehabilitation session (Ferraro et al, 2003; Hesse et al, 2003; Dipietro et al, 2005; Krebs and Hogan, 2006; Krebs et al, 2008; Volpe et al, 2008; Lo et al, 2010) These devices may include the combination of upper limb functional movements within three modalities: passive, active-assisted, or active-resisted (Ferraro et al, 2003; Dipietro et al, 2005). The objective is to establish the difference between RT and CIMT after a rehabilitation program for chronic stroke patients
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