Robot-based hand motor therapy after stroke

 With this showing improvements in chronic stroke your doctors and hospital should have realized that it would probably work even better when done much earlier. And in the 15 years since, I BET YOUR INCOMPETENT HOSPITAL HAS DONE NOTHING!

Robot-based hand motor therapy after stroke

2008, Brain

 
Robot-based hand motor therapy after stroke
Craig D.Takahashi,
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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,USA Correspondence 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: scramer@uci.edu
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 Arm Test (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 non-practiced 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
Abbreviations:
 IP=interphalangeal; MCP=metacarpophalangeal
Received July13, 2007. Revised November 27, 2007. Accepted November 28, 2007. Advance Access publication December 21, 2007