Chieh-Ling Yang, Keh-Chung Lin, Hsieh-Ching Chen, Ching-Yi Wu, Chia-Ling Chen; Pilot Comparative Study of Unilateral and Bilateral Robot-Assisted Training on Upper-Extremity Performance in Patients With Stroke. Am J Occup Ther 2012;66(2):198-206. doi: 10.5014/ajot.2012.003103.
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We compared a unilateral robot-assisted training protocol (URTP) and a bilateral robot-assisted training protocol (BRTP) to study their differential effects. We recruited 21 patients with stroke who received 90–105 min of therapy 5 days/wk for 4 wk. Participants in the URTP and BRTP groups practiced forearm pronation and supination and wrist flexion and extension in a simultaneous manner with the Bi-Manu-Track. The control group received standard rehabilitation. Clinical measures included the Fugl-Meyer Assessment, the Medical Research Council instrument, grip strength, and the Modified Ashworth Scale to assess motor impairment, muscle power, muscle strength, and spasticity, respectively. The pilot study indicated that the URTP and BRTP might have differential benefits for movement improvement. URTP might be a more compelling approach to improving upper-limb motor impairment, muscle power, and strength at the distal joints than BRTP, whereas BRTP could be an optimal approach to improving proximal muscle power.
Mode 1: passive–passive, with arms guided passively by the machine;
Mode 2: active–passive, with the nonparetic arm leading the paretic arm (i.e., the nonparetic arm actively moves the handle throughout the whole movement and the paretic arm is guided passively by the device) in a symmetric direction; and
Mode 3: active–active, with both arms performing actively by overcoming resistance.
The URTP and BRTP might have differential benefits for movement improvement.
The URTP might be a better option than the bilateral approach if the treatment goal is to improve motor impairment of the upper extremity or muscle power at the distal joint.
In contrast, the BRTP could be an optimal approach to improving muscle power at the proximal joint.
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