Robot-Assisted Therapy and Motor Learning: An Active Learning Program for Stroke
Condition: Stroke
MeSH terms: Stroke
Study type: Interventional

Summary: 
      Stroke is the leading cause of long-term disability in older adults in the United States. At
      six months after stroke, up to 65% of the more than 795,000 persons who experience a stroke
      each year continue to have motor impairments that inhibit functional use of the weaker arm
      during daily activities and negatively impact quality of life. Rehabilitation robots provide
      clinicians with new treatment options to improve movement and arm function after stroke. The
      purpose of this pilot study is to develop and test a therapy called the "Active Learning
      Program for Stroke" (ALPS). We are combining this therapy program with robot-assisted therapy
      and a home program for the stroke-affected arm and hand.
    

Detailed description: 
      Little is known about how individuals learn to utilize robot-trained movements during upper
      extremity (UE) activities in the home and community and whether specific instruction can
      enhance motor learning and carry-over.. Systematic reviews of robot-assisted therapy for the
      paretic UE confirm gains in motor capacity as measured by clinical assessments, but provide
      little evidence of improved UE performance during daily tasks and occupations. These findings
      may be attributed to the limited availability of rehabilitation robots to train the paretic
      hand and a primary focus on intensity of practice with little regard for other principles of
      motor learning and experience-dependent neuroplasticity. These principles, including the
      salience of training tasks, transfer of acquired skills to similar activities, and active
      engagement and problem solving, are key to task-oriented training paradigms in stroke (e.g.
      constraint-induced movement therapy) but have not been well integrated into robot-assisted
      therapy protocols. The transfer of robot-trained movements to UE activities within the home
      and community needs further exploration before widespread use in rehabilitation practice is
      expected.
    

Intervention name(s): Robot-Assisted Therapy (RT); Robot & Task-Oriented Training (RT-TOT)
Intervention type(s): Device; Device
Intervention description(s): Highly repetitive robot-assisted therapy for paretic arm with Armeo (1 hr sessions, 3x week for 3 weeks) followed by robot-assisted therapy for hand motions with Amadeo (3x week for 3 weeks). Robot training to be accompanied with ALPS motor learning program directed toward UE self management and transfer of training to daily activities in home & community.; Highly repetitive robot-assisted therapy for paretic arm with Armeo (30 min sessions, 3x week for 3 weeks) followed by robot-assisted therapy for hand motions with Amadeo (3x week for 3 weeks). Task oriented training will be delivered for remaining 30 mins of each treatment session. Robot and task oriented training to be accompanied with ALPS motor learning program directed toward UE self management and transfer of training to daily activities in home & community.
Allocation: Randomized
Intervention model: Factorial Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: robot-assisted therapy; task-oriented training; motor learning; cognitive strategy training