http://nnr.sagepub.com/content/early/2014/09/29/1545968314550368?papetoc
- Daniel K. Zondervan, PhD1
- Renee Augsburger2
- Barbara Bodenhoefer1
- Nizan Friedman, PhD1
- David J. Reinkensmeyer, PhD1
- Steven C. Cramer, MD1
- Daniel Zondervan, PhD, Department of Mechanical and Aerospace Engineering, UC Irvine, 2402 Calit2 Building, Irvine, CA 92697, USA. Email: dzonderv@uci.edu
Abstract
Background. Few therapeutic
options exist for the millions of persons living with severe arm
impairment after stroke to increase their
dose of arm rehabilitation. This study compared
self-guided, high-repetition home therapy with a mechanical device (the
resonating
arm exerciser [RAE]) to conventional therapy in
patients with chronic stroke and explored RAE use for patients with
subacute
stroke.
Methods. A total of 16
participants with severe upper-extremity impairment (mean Fugl-Meyer
[FM] score = 21.4 ± 8.8 out of 66) >6
months poststroke were randomized to 3 weeks of
exercise with the RAE or conventional exercises. The primary outcome
measure
was FM score 1 month posttherapy. Secondary outcome
measures included Motor Activity Log, Visual Analog Pain Scale, and
Ashworth
Spasticity Scale. After a 1-month break,
individuals in the conventional group also received a 3-week course of
RAE therapy.
Results. The change in FM score was significant in both the RAE and conventional groups after training (2.6 ± 1.4 and 3.4 ± 2.4, P = .008 and .016, respectively). These improvements were not significant at 1 month. Exercise with the RAE led to significantly
greater improvements in distal FM score than conventional therapy at the 1-month follow-up (P = .02). In a separate cohort of patients with subacute stroke, the RAE was found feasible for exercise.
Discussion.
In those with severe arm impairment after chronic stroke, home-based
training with the RAE was feasible and significantly
reduced impairment without increasing pain or
spasticity. Gains with the RAE were comparable to those found with
conventional
training and also included distal arm improvement.
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