Document Type
Article
Publication Date
10-21-2020
Abstract
Background
Studies examining the effects of therapeutic interventions after stroke often focus on changes in loss of body function/structure (impairment). However, improvements in activities limitations and participation restriction are often higher patient priorities, and the relationship that these measures have with loss of body function/structure is unclear.
Objective
This study measured gains across WHO International Classification of Function (ICF) dimensions and examined their interrelationships.
Methods
Subjects were recruited 11 to 26 weeks after hemiparetic stroke. Over a 3-week period, subjects received 12 sessions of intensive robot-based therapy targeting the distal arm. Each subject was assessed at baseline and at 1 month after end of therapy.
Results
At baseline, subjects (n = 40) were 134.7 ± 32.4 (mean ± SD) days poststroke and had moderate-severe arm motor deficits (arm motor Fugl-Meyer score of 35.6 ± 14.4) that were stable. Subjects averaged 2579 thumb movements and 1298 wrist movements per treatment session. After robot therapy, there was significant improvement in measures of body function/structure (Fugl-Meyer score) and activity limitations (Action Research Arm Test, Barthel Index, and Stroke Impact Scale–Hand), but not participation restriction (Stroke Specific Quality of Life Scale). Furthermore, while the degree of improvement in loss of body function/structure was correlated with improvement in activity limitations, neither improvement in loss of body function/structure nor improvement in activity limitations was correlated with change in participation restriction.
Conclusions
After a 3-week course of robotic therapy, there was improvement in body function/structure and activity limitations but no reduction in participation restriction.
Recommended Citation
Wu J, Dodakian L, See J, et al. Gains across WHO dimensions of function after robot-based therapy in stroke subjects. Neurorehabil Neural Repair. 2020;34(12):1150-1158. https://doi.org/10.1177/1545968320956648
Peer Reviewed
1
Copyright
The authors
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.
Comments
This is a pre-copy-editing, author-produced PDF of an article accepted for publication in Neurorehabilitation and Neural Repair, volume 34, issue 12, in 2020 following peer review. The definitive publisher-authenticated version is available online at https://doi.org/10.1177/1545968320956648.