Skip Navigation


Brain Advance Access originally published online on December 20, 2007
Brain 2008 131(2):425-437; doi:10.1093/brain/awm311
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
131/2/425    most recent
awm311v1
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Takahashi, C. D.
Right arrow Articles by Cramer, S. C.
PubMed
Right arrow PubMed Citation
Right arrow Articles by Takahashi, C. D.
Right arrow Articles by Cramer, S. C.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© The Author (2007). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Robot-based hand motor therapy after stroke

Craig D. Takahashi*, Lucy Der-Yeghiaian, Vu Le, Rehan R. Motiwala and Steven C. Cramer

Department of Neurology and Department of Anatomy & Neurobiology, University of California, Irvine, USA

Correspondence to: Steven C. Cramer, MD, University of California, Irvine Medical Center, 101 The City Drive South, Building 53 Room 203, Orange, CA 92868-4280, USA E-mail: scramer{at}uci.edu

Robots can improve motor status after stroke with certain advantages, but there has been less emphasis to date on robotic developments for the hand. The goal of this study was to determine whether a hand-wrist robot would improve motor function, and to evaluate the specificity of therapy effects on brain reorganization. Subjects with chronic stroke producing moderate right arm/hand weakness received 3 weeks therapy that emphasized intense active movement repetition as well as attention, speed, force, precision and timing, and included virtual reality games. Subjects initiated hand movements. If necessary, the robot completed movements, a feature available at all visits for seven of the subjects and at the latter half of visits for six of the subjects. Significant behavioural gains were found at end of treatment, for example, in Action Research Arm Test (34 ± 20 to 38 ± 19, P< 0.0005) and arm motor Fugl-Meyer score (45 ± 10 to 52 ± 10, P < 0.0001). Results suggest greater gains for subjects receiving robotic assistance in all sessions as compared to those receiving robotic assistance in half of sessions. The grasp task practiced during robotic therapy, when performed during functional MRI, showed increased sensorimotor cortex activation across the period of therapy, while a non-practiced task, supination/pronation, did not. A robot-based therapy showed improvements in hand motor function after chronic stroke. Reorganization of motor maps during the current therapy was task-specific, a finding useful when considering generalization of rehabilitation therapy.

Key Words: stroke; motor therapy; functional MRI; generalization

Abbreviations: IP, interphalangeal; MCP, metacarpophalangeal

.

Received July 13, 2007. Revised November 27, 2007. Accepted November 28, 2007.

*Present Address: Department of Engineering, Santa Ana College, Santa Ana, CA, USA


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?




Disclaimer:
Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.