Using Assistive Robotic Technology in Motor Neurorehabilitation After Childhood Stroke

Abstract

An intracranial haemorrhage resulted in severe motor impairment in the right upper limb in a previously physically-active young adolescent. Robot-assisted therapy was implemented over the course of 9 months to reduce motor impairment in the affected right upper limb. Robot-assisted therapy consisted of twice weekly sessions containing repetitive and progressively intense practice of hand grasping and arm reaching. The amount of assistance offered by the robot during grasping and reaching was adaptive such that as impairment reduced, the robot offered less assistance. Motor impairment was evaluated with the Fugl-Meyer assessment score for the upper limb. The robot-assisted therapy was associated with an increase in a clinical outcome measure of motor impairment following childhood stroke. The increase was distributed across both upper and lower arm segments. The final, stable reduction in motor impairment in the patient matched that demonstrated in a group of adult unilateral stroke survivors receiving similar treatment with robotics early in their recovery process. W e conclude that robot-assisted therapy offers a promising treatment option in childhood stroke involving severe upper limb motor impairment. Robot-assisted therapy could be implemented safely in an acute in-patient hospital unit and be continued after discharge to the community setting. doi:10.4021/jnr98w