Stroke Rehabilitation Possible Years Later with Robot Assisted Therapy

Kathleen Blanchard's picture
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New findings show that robot assisted devices can help patients regain limb movement years after suffering a stroke. Though the gains from robotic assistance for stroke rehabilitation were modest, the findings show that robot-assisted therapy produced statistically significant improved quality of life in patients who underwent therapy in the study.

"There are about 6.4 million stroke patients in the U.S. with chronic deficits. We've shown that with the right therapy, they can see improvements in movement, everyday function, and quality of life," said Albert Lo, assistant professor of neurology at Brown University and the study's lead author. "This is giving stroke survivors new hope." Lo explains, "One of the purposes of this study was to upend the conventional dogma that stroke victims can't recover physiological function.”

Over a period of three months, three times a week, twelve patients underwent robot assisted therapy for rehabilitation of upper limb movement. Robots guided arm movements of the upper limbs to provide more intensive exercise than administered by therapists. The two therapies were compared. A Third group received “usual” health care with no specific therapy for stroke rehabilitation.

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At the end of treatment, improvement of 8 points was noted on the Stroke Impact Scale that includes measurement of hand function, strength, ability to perform activities of daily living, communication, and memory. After six months, compared to stroke patients receiving usual care, there was a 3 point improvement on the Fugl-Meyer Scale that measures recovery after stroke in the robot assisted group.

“We believe that by gaining more function and better control of their affected arms, patients were able to get out and do more, translating their motor benefits into additional meaningful social activity and participation," said Lo, also a neurologist at the Providence VA Medical Center.

The robot used is called the MIT-Manus. Veterans were enrolled in the study, all of whom had suffered stroke at least six months prior to enrolling in the robot assisted stroke rehabilitation study. All had moderate to severe impairment of upper limb use. One third had suffered several strokes, and the average time since stroke occurrence was five years.

Using robot-assisted therapy for stroke rehabilitation is gaining momentum. Neuroplasticity — the ability of the adult brain to "rewire" itself – is a compensatory mechanism responsible for the ability of patients to recover use of their limbs even years after suffering a stroke. Robot assisted therapy is shown by the study to improve quality of life and help stroke victims regain use of their limbs through more intense therapy than conventional stroke rehabilitation.

NEJM

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Comments

My daughter had a traumatic brain injury 17yrs ago at the age of 17. She has limited use of her right arm and no use of the hand. Is there any medical facitlities in Ca. that offer this treatment. She would love to participate in a program.