A late start to stroke therapy has been thought to be detrimental to getting much benefit out of it, so exercises must begin as soon as possible. A new study, published in the New England Journal of Medicine, has now shown that even late starters can see substantial improvement when using robotically assisted therapy.
The therapy involved repetitive, guided movement, three times a week, for three months. One group of patients underwent upper-limb therapy with the use of robots designed at the Massachusetts Institute of Technology. Others did similar high-intensity exercises with a therapist. At each session, the patients performed 1,024 upper-arm movements, a substantially more intense workout than in a conventional rehabilitant protrotion session. A third, smaller group had only “usual care” — they received general health care but no specific therapy for their stroke-damaged upper limb.
Patients who had 12 weeks of robot-assisted therapy showed statistically significant improved quality of life (an eight-point improvement on the Stroke Impact Scale) compared to those who had no additional therapy. At six months, patients aided by the robotic therapy showed clinically significant upper-arm function (three-point improvement on the Fugl-Meyer Scale) compared to the usual care group.
To measure the impact on everyday life, researchers asked patients a battery of questions: how well they could cut food with a fork and knife, open jars, or tie their shoes. Patients were also asked about activities not directly related to their arms, such as walking or climbing stairs. Most patients in the therapy groups reported across-the-board progress, compared with no progress in the control group.
Full article in NEJM: Robot-Assisted Therapy for Long-Term Upper-Limb Impairment after Stroke
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