Robot-assisted upper-limb therapy in acute rehabilitation setting following stroke: Department of Veterans Affairs multisite clinical trial

This randomized, controlled, multisite Departmentof Veterans Affairs clinical trial assessed robot-assisted (RA)upper-limb therapy with the Mirror Image Movement Enabler(MIME) in the acute stroke rehabilitation setting. Hemipareticsubjects (n = 54) received RA therapy using MIME for either upto 15 hours (low-dose) or 30 hours (high-dose) or received up to15 hours of additional conventional therapy in addition to usualcare (control). The primary outcome measure was the Fugl-Meyer Assessment (FMA). The secondary outcome measureswere the Functional Independence Measure (FIM), Wolf MotorFunction Test, Motor Power, and Ashworth scores at intake, discharge,and 6-month follow-up. Mean duration of study treatmentwas 8.6, 15.8, and 9.4 hours for the low-dose, high-dose,and control groups, respectively. Gains in the primary outcomemeasure were not significantly different between groups at follow-up. Significant correlations were found at discharge betweenFMA gains and the dose and intensity of RA. Intensity also correlatedwith FMA gain at 6 months. The high-dose group hadgreater FIM gains than controls at discharge and greater tone butno difference in FIM changes compared with low-dose subjectsat 6 months. As used during acute rehabilitation, motor-controlchanges at follow-up were no less with MIME than with additionalconventional therapy. Intensity of training with MIME waspositively correlated with motor-control gains.