Highlights
- •We examined the feasibility of a combined clinic-home–based intervention using an electromyography-controlled wearable robotic elbow brace.
- •The 6-week home program was feasible and effective.
- •Participants had significant improvements in arm impairment and self-reported functional use of the arm from baseline to discharge and continued to report significant improvement in actual use at 3-month follow-up.
Abstract
Objective
To investigate the feasibility of a combined clinic-home intervention using a robotic
elbow brace and, secondarily, to collect preliminary data on the efficacy of this
clinic-home intervention.
Design
Nonrandomized pre-/postinterventional study.
Setting
Outpatient clinic and participants' homes.
Participants
Individuals at least 6 months after stroke (N=11; 5 women and 6 men; mean age, 51.7y;
mean time since stroke, 7.6y; mean Fugl-Meyer Assessment of the Upper Extremity [FMA-UE]
score, 22 of 66) were enrolled from the community.
Interventions
Participants received training in an outpatient clinic from an experienced occupational
therapist to gain independence with use of the device (3–9 sessions) followed by a
6-week home program using the device at home.
Main Outcome Measures
Five instruments were administered before and after the study intervention: Modified
Ashworth Scale, Box and Blocks test, FMA-UE, Arm Motor Ability Test, and Motor Activity
Log-Amount of Use and Motor Activity Log-How Well subscales (MAL-AOU, MAL-HW).
Results
Nine participants completed the study. Participants used the device on average 42.9min/d,
5.3d/wk. The FMA-UE (t=3.32; P=.01), MAL-AOU (t=4.40; P=.002), and MAL-HW (t=4.02; P=.004) scores showed statistically significant improvement from baseline to discharge;
the MAL-AOU (t=2.61; P=.035) and MAL-HW (t=2.47; P=.043) scores were also significantly improved from baseline to 3-month follow-up.
Conclusions
This combined clinic-home intervention was feasible and effective. Participants demonstrated
improvements in arm impairment and self-reported use of the arm from baseline to discharge;
they continued to report significant improvement in actual use of the arm at 3-month
follow-up.
Keywords
List of abbreviations:
FMA-UE (Fugl-Meyer Assessment of the Upper Extremity), MAL-AOU (Motor Activity Log-Amount of Use subscale), MAL-HW (Motor Activity Log-How Well subscale), MAS (Modified Ashworth Scale)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: July 16, 2015
Footnotes
The devices used during the study were provided by Myomo, Inc. No other funding was provided, and Myomo did not have any involvement in the design, conduct, or reporting of this study.
Disclosures: J. Stein has served on the scientific advisory board of Myomo, Inc; received nonfinancial support from Tyromotion, Inc; and grant funding from Nexstim, Inc. The other authors have nothing to disclose.
Identification
Copyright
© 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
