Robot-assisted reaching exercise promotes arm movement recovery in chronic hemiparetic stroke: a randomized controlled pilot study

So no additional benefit. It wouldn't help most survivors anyway since by the time you're chronic there is no way insurance will pay for this and you couldn't afford it anyways.

Robot-assisted reaching exercise promotes arm movement recovery in chronic hemiparetic stroke: a randomized controlled pilot study

 LeonardEKahn*
1,2
, MicheleLZygman
1
, W ZevRymer
1,2,3
 and DavidJReinkensmeyer
1,4
 Address:
1
Sensory Motor Performance Program, Rehabilitation Institute of Chicago, Chicago, Illinois, USA,
2
Department of Biomedical Engineering, Northwestern University, Evanston, Illinois, USA,
3
Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA and
4
Department of Mechanical and Aerospace Engineering, Center for Biomedical Engineering, University of California, Irvine, California, USA Email: LeonardEKahn*-l-kahn@northwestern.edu; MicheleLZygman-m_zygman@hotmail.com; W ZevRymer-w-rymer@northwestern.edu; DavidJReinkensmeyer-dreinken@uci.edu* Corresponding author

Abstract

Background and purpose:
 

Providing active assistance to complete desired arm movements is a common technique in upper extremity rehabilitation after stroke. Such active assistance may improve recovery by affecting somatosensory input, motor planning, spasticity or soft tissue properties, but it is labor intensive and has not been validated in controlled trials. The purpose of this study was to investigate the effects of robotically administered active-assistive exercise and compare those with free reaching voluntary exercise in improving arm movement ability after chronic stroke.
 

Methods:
 

Nineteen individuals at least one year post-stroke were randomized into one of two groups.One group performed 24 sessions of active-assistive reaching exercise with a simple robotic device, while a second group performed a task-matched amount of unassisted reaching. The main outcome measures were range and speed of supported arm movement, range, straightness and smoothness of unsupported reaching, and the Rancho Los Amigos Functional Test of Upper Extremity Function.
 

Results and discussion:
 

There were significant improvements with training for range of motion andvelocity of supported reaching, straightness of unsupported reaching, and functional movement ability.These improvements were not significantly different between the two training groups. The group thatperformed unassisted reaching exercise improved the smoothness of their reaching movements morethan the robot-assisted group.
 

Conclusion:
 

Improvements with both forms of exercise confirmed that repeated, task-related voluntary activation of the damaged motor system is a key stimulus to motor recovery following chronic stroke.Robotically assisting in reaching successfully improved arm movement ability, although it did not provide any detectable, additional value beyond the movement practice that occurred concurrently with it. The inability to detect any additional value of robot-assisted reaching may have been due to this pilot study's limited sample size, the specific diagnoses of the participants, or the inclusion of only individuals with chronic stroke.