Thursday, August 2, 2012

Study Compares Therapist-Based and Robot-Assisted Bilateral Arm Training After Stroke

Work with your PT to come up with a home program. I would love to see exactly what this means.
http://www.ptproductsonline.com/news/2012-08-02_01.asp
Bilateral arm training (BAT) has been widely studied, however, the comparative effects of therapist-based BAT (TBAT) and robot-assisted BAT (RBAT) are unknown. Researchers in Taiwan performed a study to compare the efficacy of TBAT, RBAT, and a control treatment (CT) on motor control, functional performance, and quality of life after a chronic stroke. The results were published in the August 2012 issue of Physical Therapy.
Ching-yi Wu, ScD, OTR, from the department of occupational therapy and graduate institute of behavioral sciences at Chang Gung University, Taoyuan, Taiwan, led the study of 42 patients with an average age of 54.49 years and an average length of 17.62 months since the onset of stroke. The patients were randomly assigned to TBAT, RBAT, and CT groups, with each group receiving treatment for 90 minutes to 105 minutes per session. There were five sessions, held on weekdays for 4 weeks. Outcome measures for the study included kinematic analyses, the Fugl-Meyer Assessment (FMA), the Motor Activity Log, and the Stroke Impact Scale (SIS).
According to the results, large and significant effects were found in the kinematic variables, the distal part of upper-limb motor impairment, and certain aspects of quality of life in favor of TBAT or RBAT. The researchers found that the TBAT group demonstrated significantly better temporal efficiency and smoothness, straighter trunk motion, and less trunk compensation. The RBAT group reportedly had increased shoulder flexion. Furthermore, on the FMA, the TBAT group showed higher distal part scores than the CT group and, on the SIS, the RBAT group had better strength subscale, physical function domain, and total scores than the CT group.
The researchers conclude that, compared with CT, TBAT and RBAT exhibited differential effects on outcome measures. TBAT may improve temporal efficiency, smoothness, trunk control, and motor impairment of the distal upper limb, while RBAT may improve shoulder flexion and quality of life. The authors note that this study recruited patients with mild spasticity and without cognitive impairments.

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