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The effect of the GENTLE/s robot-mediated therapy system on arm function after stroke

Department of Physiotherapy, University of Limerick, Limerick, Susan.coote{at}ul.ie

Brendan Murphy

School of Mathematical Sciences (Statistics), University College Dublin, Dublin, Ireland

William Harwin

Cybernetics Department, University of Reading, Reading, UK

Emma Stokes

Department of Physiotherapy, Trinity College Dublin, Ireland

Objective: To evaluate the effect of robot-mediated therapy on arm dysfunction post stroke.

Design: A series of single-case studies using a randomized multiple baseline design with ABC or ACB order. Subjects (n = 20) had a baseline length of 8, 9 or 10 data points. They continued measurement during the B — robot-mediated therapy and C — sling suspension phases.

Setting: Physiotherapy department, teaching hospital.

Subjects: Twenty subjects with varying degrees of motor and sensory deficit completed the study. Subjects attended three times a week, with each phase lasting three weeks.

Interventions: In the robot-mediated therapy phase they practised three functional exercises with haptic and visual feedback from the system. In the sling suspension phase they practised three single-plane exercises. Each treatment phase was three weeks long.

Main measures: The range of active shoulder flexion, the Fugl-Meyer motor assessment and the Motor Assessment Scale were measured at each visit.

Results: Each subject had a varied response to the measurement and intervention phases. The rate of recovery was greater during the robot-mediated therapy phase than in the baseline phase for the majority of subjects. The rate of recovery during the robot-mediated therapy phase was also greater than that during the sling suspension phase for most subjects.

Conclusion: The positive treatment effect for both groups suggests that robot-mediated therapy can have a treatment effect greater than the same duration of non-functional exercises. Further studies investigating the optimal duration of treatment in the form of a randomized controlled trial are warranted.

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