So, in the past 12 years were any protocols written and distributed on this? And did your hospital do ONE DAMN THING WITH THIS EXCEPT IGNORE IT?
Lucy Der-Yeghiaian,Vu Le, Rehan R. Motiwala and Steven C.Cramer
Department of Neurology and Department of Anatomy & Neurobiology,University of California, Irvine,USA*Present Address: Department of Engineering, Santa Ana College, Santa Ana,CA,USACorrespondence to: Steven C.Cramer, MD,University of California, Irvine Medical Center,101The City Drive South,Building 53 Room 203,Orange,CA 92868-4280,USAE-mail: firstname.lastname@example.org
Robots can improve motor status after stroke with certain advantages, but there has been less emphasis to date on robotic developments for the hand. The goal of this study was to determine whether a hand-wrist robot would improve motor function, and to evaluate the specificity of therapy effects on brain reorganization.Subjects with chronic stroke producing moderate right arm/hand weakness received 3 weeks therapy that emphasized intense active movement repetition as well as attention, speed, force, precision and timing, and included virtual reality games. Subjects initiated hand movements. If necessary, the robot completed movements, a feature available at all visits for seven of the subjects and at the latter half of visits for six of the subjects. Significant behavioural gains were found at end of treatment, for example, in Action Research ArmTest (34 ± 20 to 38 ±19, P < 0.0005) and arm motor Fugl-Meyer score (45 ± 10 to 52 ±10, P <0.0001). Results suggest greater gains for subjects receiving robotic assistance in all sessions as compared to those receiving robotic assistance in half of sessions.The grasp task practiced during robotic therapy, when performed during functional MRI, showed increased sensorimotor cortex activation across the period of therapy, while a nonpracticed task, supination/pronation, did not. A robot-based therapy showed improvements in hand motor function after chronic stroke. Reorganization of motor maps during the current therapy was task-specific, a finding useful when considering generalization of rehabilitation therapy.Keywords:
stroke; motor therapy; functional MRI; generalization
Received July13, 2007. Revised November 27, 2007. Accepted November 28, 2007. Advance Access publication December 21, 2007