Cherry picking and I see no reference to any protocol. But they have had 8 years to make it better, I'm not looking for it, your doctor should know about followup to this.
Effect of Therapist-Based Versus Robot-Assisted Bilateral Arm Training on Motor Control, Functional Performance, and Quality of Life After Chronic Stroke: A Clinical Trial
2012, Physical Therapy
Ching-yi Wu, Chieh-ling Yang, Li-ling Chuang, Keh-chung Lin, Hsieh-ching Chen,Ming-de Chen, Wan-chien Huang
Background.
Although bilateral arm training (BAT) has been widely studied, the comparative effects of therapist-based BAT (TBAT) versus robot-assisted BAT (RBAT) remained unknown.
Objective.
This study compared the efficacy of TBAT, RBAT, and a control treatment (CT) on motor control, functional performance, and quality of life after chronic stroke.
Design.
A randomized, pretest posttest, control group design was used.
Methods.
Forty-two patients (mean age=54.49 years, SD=9.69; mean length of time since stroke onset=17.62 months, SD=10.50) were randomly assigned to TBAT,RBAT, and CT groups. Each group received treatment for 90 to 105 minutes per session, 5 sessions on weekdays, for 4 weeks. Outcome measures included kinematicanalyses, the Fugl-Meyer Assessment (FMA), the Motor Activity Log, and the StrokeImpact Scale (SIS).
Results.
Large and significant effects were found in the kinematic variables, distal part of upper-limb motor impairment, and certain aspects of quality of life in favor of TBAT or RBAT. Specifically, the TBAT group demonstrated significantly better temporal efficiency and smoothness, straighter trunk motion, and less trunk compensation compared with the CT and RBAT groups. The RBAT group had increased shoulder flexion compared with the CT and TBAT groups. On the FMA, the TBAT group showed higher distal part scores than the CT group. On the SIS, the RBAT group had better strength subscale, physical function domain, and total scores than the CT group.
Limitations.
This study recruited patients with mild spasticity and without cognitive impairment.(So, they cherry picked the already better off survivors.)
Conclusions.
Compared with CT, TBAT and RBAT exhibited differential effectson outcome measures. Therapist-based BAT may improve temporal efficiency,smoothness, trunk control, and motor impairment of the distal upper limb. Robot-assisted BAT may improve shoulder flexion and quality of life.
C. Wu, ScD, OTR, Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, Chang Gung University,Taoyuan, Taiwan.C. Yang, MS, Department of Occupational Therapy and Gradu-ate Institute of Behavioral Sciences, Chang Gung University.L. Chuang, PT, PhD, School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.K. Lin, ScD, OTR, School of Occupational Therapy, College of Medicine, National Taiwan University,and Division of Occupational Therapy, Department of Physical Medicine and Rehabilitation,National Taiwan University Hospi-tal, 17, F4, Xu Zhou Road, Taipei,Taiwan. Address all correspondence to Dr Lin at: kehchunglin@ntu.edu.tw.H. Chen, PhD, Department and Graduate Institute of Industrial Engineering and Management,National Taipei University of Technology, Taipei, Taiwan.M.Chen,PhD,OT,Department of Occupational Therapy and Gradu-ate Institute of Behavioral Sciences, Chang Gung University. W. Huang, MS, Division of Occupational Therapy, Department of Physical Medicine and Rehabilitation, En Chu Kong Hospital, NewTaipei City, Taiwan.Ms Yang and Dr Chuang contributed equally to the manuscript.[Wu C, Yang C, Chuang L, et al.Effect of therapist-based versus robot assisted bilateral arm training on motor control, functional performance, and quality of life after chronic stroke: a clinical trial.
Phys Ther.
2012;92:xxx–xxx.]© 2012 American Physical Therapy AssociationPublished Ahead of Print: April 19, 2012 Accepted: April 11, 2012Submitted: September 2, 2011
Research Report
Post a Rapid Response to this article at:
ptjournal.apta.org
August 2012 Volume 92 Number 8 Physical Therapy
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1
at NTU Medical Library on June 9, 2012http://ptjournal.apta.org/ Downloaded from
Ching-yi Wu, Chieh-ling Yang, Li-ling Chuang, Keh-chung Lin, Hsieh-ching Chen,Ming-de Chen, Wan-chien Huang
Background.
Although bilateral arm training (BAT) has been widely studied, the comparative effects of therapist-based BAT (TBAT) versus robot-assisted BAT (RBAT) remained unknown.
Objective.
This study compared the efficacy of TBAT, RBAT, and a control treatment (CT) on motor control, functional performance, and quality of life after chronic stroke.
Design.
A randomized, pretest posttest, control group design was used.
Methods.
Forty-two patients (mean age=54.49 years, SD=9.69; mean length of time since stroke onset=17.62 months, SD=10.50) were randomly assigned to TBAT,RBAT, and CT groups. Each group received treatment for 90 to 105 minutes per session, 5 sessions on weekdays, for 4 weeks. Outcome measures included kinematicanalyses, the Fugl-Meyer Assessment (FMA), the Motor Activity Log, and the StrokeImpact Scale (SIS).
Results.
Large and significant effects were found in the kinematic variables, distal part of upper-limb motor impairment, and certain aspects of quality of life in favor of TBAT or RBAT. Specifically, the TBAT group demonstrated significantly better temporal efficiency and smoothness, straighter trunk motion, and less trunk compensation compared with the CT and RBAT groups. The RBAT group had increased shoulder flexion compared with the CT and TBAT groups. On the FMA, the TBAT group showed higher distal part scores than the CT group. On the SIS, the RBAT group had better strength subscale, physical function domain, and total scores than the CT group.
Limitations.
This study recruited patients with mild spasticity and without cognitive impairment.(So, they cherry picked the already better off survivors.)
Conclusions.
Compared with CT, TBAT and RBAT exhibited differential effectson outcome measures. Therapist-based BAT may improve temporal efficiency,smoothness, trunk control, and motor impairment of the distal upper limb. Robot-assisted BAT may improve shoulder flexion and quality of life.
C. Wu, ScD, OTR, Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, Chang Gung University,Taoyuan, Taiwan.C. Yang, MS, Department of Occupational Therapy and Gradu-ate Institute of Behavioral Sciences, Chang Gung University.L. Chuang, PT, PhD, School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.K. Lin, ScD, OTR, School of Occupational Therapy, College of Medicine, National Taiwan University,and Division of Occupational Therapy, Department of Physical Medicine and Rehabilitation,National Taiwan University Hospi-tal, 17, F4, Xu Zhou Road, Taipei,Taiwan. Address all correspondence to Dr Lin at: kehchunglin@ntu.edu.tw.H. Chen, PhD, Department and Graduate Institute of Industrial Engineering and Management,National Taipei University of Technology, Taipei, Taiwan.M.Chen,PhD,OT,Department of Occupational Therapy and Gradu-ate Institute of Behavioral Sciences, Chang Gung University. W. Huang, MS, Division of Occupational Therapy, Department of Physical Medicine and Rehabilitation, En Chu Kong Hospital, NewTaipei City, Taiwan.Ms Yang and Dr Chuang contributed equally to the manuscript.[Wu C, Yang C, Chuang L, et al.Effect of therapist-based versus robot assisted bilateral arm training on motor control, functional performance, and quality of life after chronic stroke: a clinical trial.
Phys Ther.
2012;92:xxx–xxx.]© 2012 American Physical Therapy AssociationPublished Ahead of Print: April 19, 2012 Accepted: April 11, 2012Submitted: September 2, 2011
Research Report
Post a Rapid Response to this article at:
ptjournal.apta.org
August 2012 Volume 92 Number 8 Physical Therapy
f
1
at NTU Medical Library on June 9, 2012http://ptjournal.apta.org/ Downloaded from
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