Deans' stroke musings: Abstract TP137: Robotic Upper Limb Therapy by a Trained Volunteer on an Inpatient Stroke Rehabilitation Unit

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Sunday, February 26, 2017

Abstract TP137: Robotic Upper Limb Therapy by a Trained Volunteer on an Inpatient Stroke Rehabilitation Unit

Well shit why have a stroke department at all? No need for a doctor since all the doctor does is write three prescriptions for E.T.(Evaluate and Treat) to the PT, OT and ST. Therapists can just train volunteers and ship the patient home for home therapy. Can't be any worse than the 10% full recovery your get from your doctor and therapists.
http://stroke.ahajournals.org/content/48/Suppl_1/ATP137

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Stroke. 2017;48:ATP137

Abstract

Introduction: Having a therapist observe patients engaged in Robotic Upper Limb Therapy (RULT) is considered inefficient use of a therapist’s time and skill. We therefore assessed the feasibility of (RULT) administered by a trained volunteer.

Methods: The Volunteer had two 30-minute training sessions by an Occupational Therapist (OT) rehearsing the MIT-Manus Planar Upper Limb Robotic software applications, proper positioning of the patient, and device shut-off and safety considerations. Initial patient sessions were supervised by the patient’s OT until the Volunteer demonstrated satisfactory performance. Inpatients on a Stroke Rehabilitation Unit were referred by their OT for RULT if they could initiate horizontal gravity-eliminated movement of the forearm and could follow one step commands. They were enrolled in 25 minute (RULT) sessions based upon the Volunteer’s availability from one to three half-days per week. Functional Independence Measures and Fugl-Meyer Scores were recorded at the time of Stroke Unit Admission by the OT unaware of (RULT) score results. Statistical analyses were performed using SPSS version 11.5 and significance was attributed if p<0.05 using 2-tailed analyses.

Results: A total of 28 patients were enrolled in (RULT) but 2 were unable to participate due to pain in the affected upper limb. Participants had a mean of 3 ± 1.5 SD treatments each. Both the patients and volunteer considered their involvement in the program as worthwhile and meaningful. Admission MIT-Manus Adaptive-3 treatment software data showed that the Normalized Jerk+Line+Target (Norm JLT) Score [defined as (Jerk Score/237)+(Deviation from a Straight Line/13)+(Target Distance Error/14)] demonstrated a significant Spearman-rho Correlation with admission Functional Independence Measure (FIM) upper dressing r = -0.56 p=.003; and FIM grooming subscores r = -0.415, p=.035. The Norm JLT score also predicted change in Fugl-Meyer Upper Limb scores from admission to discharge r = - .788, p = 0.000.

Conclusions: Robotic Upper Limb Therapy by a trained Volunteer on an inpatient Stroke Rehabilitation Unit is easily administered, is viewed by the patients and volunteer as rewarding, and provides objective measures useful for assessing upper limb function and outcome. But no mention of recovery results using this.