Three ways to improve arm function in the chronic phase after stroke by robotic priming combined with mirror therapy, arm training and movement-oriented therapy

Arch Phys Med Rehabil. 2023 Mar 16:S0003-9993(23)00150-8. doi: 10.1016/j.apmr.2023.02.015. Online ahead of print.


OBJECTIVE: To examine the effects of bilateral robotic priming combined with mirror therapy (R-mirr) versus bilateral robotic priming combined with bilateral arm training (R-bilat), relative to the control approach of bilateral robotic priming combined with movement-oriented training (R-mov) in patients with stroke.

DESIGN: A single-blind, preliminary, randomized controlled trial.

SETTING: Four outpatient rehabilitation settings.

PARTICIPANTS: Outpatients with stroke and mild to moderate motor impairment (N = 63).

INTERVENTIONS: Patients received 6 weeks of clinic-based R-mirr, R-bilat, or R-mov for 90 minutes/day, 3 days/week, plus a transfer package at home for 5 days/week.

MAIN OUTCOME MEASURES: Fugl-Meyer Assessment upper extremity subscale (FMA-UE), ABILHAND, and Stroke Impact Scale (SIS) version 3.0 scores before, immediately after, and 3 months after treatment as well as the lateral pinch strength and the accelerometry before and immediately after treatment.

RESULTS: The posttest results favored R-mirr over R-bilat and R-mov on the FMA-UE score (P<.05). Follow-up analysis revealed that significant improvement in FMA-UE score was retained at the 3-month follow-up in the R-mirr over R-bilat or R-mov (P<.05). Significant improvements were not observed in the R-mirr over R-bilat and R-mov on other outcomes.

CONCLUSIONS: Between-groups differences were only detected for the primary outcome – FMA-UE. That was R-mirr was more effective at enhancing upper-limb motor improvement, and the effect has the potential to be maintained at 3 months of follow-up.

PMID:36933609 | DOI:10.1016/j.apmr.2023.02.015

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