Robot-assisted Hand Rehabilitation for Patients With Stroke
Condition: Stroke
MeSH terms: Stroke
Study type: Interventional

Summary: 
      Robotic therapy can deliver larger amounts of upper extremity movement practice for stroke
      rehabilitation. Although the treatment effects were supported in studies, there are still
      limitations in clinical intervention. The study will use the robot-assisted hand
      rehabilitation with a Gloreha device. Thirty patients with moderate motor deficits were
      recruited and randomized into 2 treatment groups, AB or BA (A = 12 times of robot-assisted
      hand rehabilitation, B = 12 times of standard therapy) for 12 weeks of treatment (Sixty
      minutes a time, twice a week), 1 month of break between conditions for washout period. The
      performance was assessed by a blinded assessor for five times (pre-test1, post-test 1,
      pre-test2, post-test 2, follow up at three month). The outcome measures Fugl-Meyer
      Assessment-Upper Limb section(FMA-UE),Box and block test(BBT), Maximal voluntary
      contraction(MVC) of extensor digitorum communis(EDC), Abductor pollicis brevis(APB), Flexor
      digitorum(FD), Dynanometer, Semmes-Weinstein hand monofilament (SWM), Revision of the
      Nottingham Sensory Assessment (EmNSA), Modified Barthel Index. Collected data will be
      analyzed with ANOVA test by SPSS version 20.0, and alpha level was set at 0.05. The
      hypothesis are robot-assisted hand rehabilitation with a Gloreha device has positive effects
      on sensory, motor, hand function, and ADL ability among patients with stroke.
    

Detailed description: 
      Many stroke survivors suffered problems with the upper extremity, such as paresis, synergy
      movement, hypertonicity, jag movement, sensory deficit. An inability to use the upper
      extremity in daily life can lead to loss of independence with ADLs and of important
      occupations (eg,work, driving). For individuals with more severe paresis, the potential for
      recovery of upper extremity function is greatly reduced. Robotic therapy can deliver larger
      amounts of upper extremity movement practice for these individuals. Although the Robotic
      therapy appears to provide some benefit for upper extremity motor abilities and participation
      but is of uncertain utility compared with dose-matched conventional upper limb exercise
      therapies. Objective: To investigate the effects of robot-assisted hand rehabilitation with a
      Gloreha device on sensory, motor, and ADL ability for patients with stroke.

      Materials and Methods: Thirty patients with moderate motor deficits were recruited and
      randomized into 2 treatment groups, AB or BA (A = 12 times of robot-assisted hand
      rehabilitation, B = 12 times of standard therapy) for 12 weeks of treatment (Sixty minutes a
      time, twice a week), 1 month of break between conditions for washout period. The performance
      was assessed by a blinded assessor for five times (pre-test1, post-test 1, pre-test2,
      post-test 2, follow up at three month). The outcome measures Fugl-Meyer Assessment-Upper Limb
      section(FMA-UE),Box and block test(BBT), Maximal voluntary contraction(MVC) of extensor
      digitorum communis(EDC), Abductor pollicis brevis(APB), Flexor digitorum(FD), Dynanometer,
      Semmes-Weinstein hand monofilament (SWM), Revision of the Nottingham Sensory Assessment
      (EmNSA) for hand evaluations, Modified Barthel Index for ADL ability. Collected data will be
      analyzed with ANOVA test by SPSS version 20.0, and alpha level was set at 0.05. The
      hypothesis are robot-assisted hand rehabilitation with a Gloreha device has positive effects
      on sensory, motor, hand function, and ADL ability among patients with stroke.
    

Intervention name(s): Robot-assisted hand rehabilitation; Standard treatment
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Robot-assisted hand rehabilitation: 20 minute of worm-up exercise and 40 minute of robot-assisted hand exercise. Robot-assisted hand exercises include passive range of motion of hand, bilateral hands task and robot-assisted task.; Standard treatment only group: 60 min standard treatment. 20 minute of worm-up exercise and 40 minute of traditional occupational therapy. Traditional occupational therapy include spasticity-reducing activity, bilateral hands activity and hand training task.
Allocation: Randomized
Intervention model: Crossover Assignment
Intervention model description: AB or BA
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Stroke; Robotic rehabilitation; Hand function; Activities of Daily Living