Robot-Assisted Therapy and Motor Learning: An Active Learning Program for Stroke

The FMA will examine changes in motor function, pain and sensation in the paretic UE between baseline, post-intervention and 1-month follow-up assessments. The FMA upper extremity subtest contains 33 items, scored as 0= unable, 1=partial ability, 2= faultless with a total possible score of 66 points. Change was calculated as the value at the 1 month follow-up assessment minus the value at baseline to reflect retention of motor function following intervention.

Time frame: Baseline and 1-month follow-up

Population: Primary aims were to examine the feasibility and effects of the Active Learning Program for Stroke (ALPS) on paretic upper extremity function when combined with either robot-assisted therapy or robot-assisted therapy plus task-oriented training. In the 3rd Arm, data from both groups were combined to examine effects of ALPS + intensive UE training.

The WMFT examined changes in ability to complete timed, functionally-based activities with the paretic UE between baseline, post-intervention and 1-month follow-up assessments. The task rate was calculated as the average # of times that each test item could be completed within 1 minute. Here we report the change in task rate scores between admission and 1 month follow-up assessments to reflect retention of motor function following intervention. A higher number indicates improved task completion.

Time frame: Baseline and 1-month follow-up

Population: Primary aims were to examine the feasibility and effects of the Active Learning Program for Stroke (ALPS) on paretic upper extremity function when combined with either robot-assisted therapy or robot-assisted therapy plus task-oriented training. In the 3rd Arm, data from both groups were combined to examine effects of ALPS + intensive UE training.

The CAHM is a self-report assessment in which participants are asked to rate their confidence (0-100%) in successfully using their paretic UE for a variety of everyday activities. Change in confidence ratings between baseline, post-intervention and 1-month follow up assessments were examined. A higher score indicates greater confidence. We report change scores between admission and 1 month follow up assessments to reflect retention of scores following intervention.

Time frame: Baseline and 1-month follow-up

Population: Primary aims were to examine the feasibility and effects of the Active Learning Program for Stroke (ALPS) on paretic upper extremity function when combined with either robot-assisted therapy or robot-assisted therapy plus task-oriented training. In the 3rd Arm, data from both groups were combined to examine effects of ALPS + intensive UE training.

Participants were asked to reach forward from a designated starting position toward a panel with 12 numbered targets positioned in a clockwise-fashion 20 cm from from its center. The center of the target was aligned with the acromion of the paretic arm and reflective markers were attached to locations on the trunk and paretic arm to allow recording of kinematic data via 3-D motion capture (Vicon Motion Systems Ltd. UK) for off-line analysis. Data from reaching movements to all targets were combined for analysis. We report the median values for Log Normalized Jerk, a measure of movement smoothness during reach, for the entire sample at the time of a discharge assessment immediately following the 6-week intervention.

Time frame: Baseline and immediately after 6-week intervention

Population: Because the primary aim of this pilot was to explore the combined effects of the Active Learning Program for Stroke (ALPS ) and robot-assisted therapy/task oriented training, a decision was made a priori that this data would be collected and analyzed in a pooled manner for this exploratory endpoint.

Participants were asked to reach forward from a designated starting position toward a panel with 12 numbered targets positioned in a clockwise-fashion 20 cm from from its center. The center of the target was aligned with the acromion of the paretic arm and reflective markers were attached to locations on the trunk and paretic arm to allow recording of kinematic data via 3-D motion capture (Vicon Motion Systems Ltd. UK) for off-line analysis. Data from reaching movements to all targets were combined for analysis. We report the median values for Movement Time (sec) for the entire sample at the time of a discharge assessment immediately following the 6-week intervention.

Time frame: Baseline and immediately after 6-week intervention

Population: Because the primary aim of this pilot was to explore the combined effects of the Active Learning Program for Stroke (ALPS ) and robot-assisted therapy/task oriented training, a decision was made a priori that this data would be collected and analyzed in a pooled manner for this exploratory endpoint.

The MAS examined changes in muscle tone in the paretic UE . Scores range from 0=no increase in muscle tone to 4=affected part(s) rigid in flexion or extension. Tested muscle groups include shoulder internal rotators, elbow flexors/extensors, supinators, pronators, wrist flexors/extensors, finger flexors/extensors. Lower scores indicate better motor function. We present the change scores between admission and 1 month follow up assessments to reflect retention of motor function following intervention. .

Time frame: Baseline and 1-month follow-up

Population: Primary aims were to examine the feasibility and effects of the Active Learning Program for Stroke (ALPS) on paretic upper extremity function when combined with either robot-assisted therapy or robot-assisted therapy plus task-oriented training. In the 3rd Arm, data from both groups were combined to examine effects of ALPS + intensive UE training.

The MAL has been widely used in stroke rehabilitation studies to measure self-reported amount and quality of paretic arm use during daily activities. Participant's self-reported amount of use (AOU) and how well the task was performed (HW) are rated on a scale from 0=not used at all to 5=as much or as well as before the stroke. Higher scores indicate greater perceived motor function in the paretic arm & hand. We report change scores in amount of use (AOU) between admission and 1 month follow up assessments to reflect retention of motor function following intervention..

Time frame: Baseline and 1-month follow-up

Population: Primary aims were to examine the feasibility and effects of the Active Learning Program for Stroke (ALPS) on paretic upper extremity function when combined with either robot-assisted therapy or robot-assisted therapy plus task-oriented training. In the 3rd Arm, data from both groups were combined to examine effects of ALPS + intensive UE training.

The MAL has been widely used in stroke rehabilitation studies to measure self-reported amount and quality of paretic arm use during daily activities. Participant's self-reported amount of use (AOU) and how well the task was performed (HW) are rated on a scale from 0=not used at all to 5=as much or as well as before the stroke. Higher scores indicate greater perceived motor function in the paretic arm & hand. We report change scores in how well the function was performed between admission and 1 month follow up assessments to reflect retention of motor function following intervention..

Time frame: Baseline and 1-month follow-up

Population: Primary aims were to examine the feasibility and effects of the Active Learning Program for Stroke (ALPS) on paretic upper extremity function when combined with either robot-assisted therapy or robot-assisted therapy plus task-oriented training. In the 3rd Arm, data from both groups were combined to examine effects of ALPS + intensive UE training.

The SIS measured changes in activity and participation due to stroke. The SIS assesses eight domains including strength, hand function, activities of daily living/instrumental activities of daily living, mobility, communication, emotion, memory & thinking, and participation/role function. A transformed score for each domain is calculated from its raw score and represented by a 100 point scale, with higher scores representing better performance. We report the change in transformed scores for the hand function domain, between admission and 1 month follow up assessments to reflect retention of motor function following intervention.

Time frame: Baseline and 1-month follow-up

Population: Primary aims were to examine the feasibility and effects of the Active Learning Program for Stroke (ALPS) on paretic upper extremity function when combined with either robot-assisted therapy or robot-assisted therapy plus task-oriented training. In the 3rd Arm, data from both groups were combined to examine effects of ALPS + intensive UE training.

The SIS measures changes in activity and participation due to stroke. The SIS assesses eight domains including strength, hand function, activities of daily living/instrumental activities of daily living, mobility, communication, emotion, memory & thinking, and participation/role function. A transformed score for each domain is calculated from its raw score and represented by a 100 point scale, with higher scores representing better performance. We report the participants' rating of stroke recovery (how much the participant feels that he/she has recovered from stroke with 0=no recovery, 100=full recovery), between admission and 1 month follow up assessments to reflect retention of motor function following intervention.

Time frame: Baseline and 1-month follow-up

Population: Primary aims were to examine the feasibility and effects of the Active Learning Program for Stroke (ALPS) on paretic upper extremity function when combined with either robot-assisted therapy or robot-assisted therapy plus task-oriented training. In the 3rd Arm, data from both groups were combined to examine effects of ALPS + intensive UE training.