Research Shows New Training Method Enhances Recovery of Hand Function in Stroke Patients
Rehabilitation Institute of Chicago (RIC) Researchers Pioneer Use of Robotics in Stroke Rehabilitation
February 13, 2006
CHICAGO, IL - A new study by Rehabilitation Institute of Chicago (RIC) researchers demonstrates that the Institute's 'adaptive training' robotic technology is effective in helping patients recover from stroke.
Published in the January issue of the journal Experimental Brain Research, the study showed that adaptive training significantly improves stroke patients' affected arm functions following training sessions.
With adaptive training, robots are attached to stroke patients' arms to help them improve their range of motion and hand functions. While existing methods of robotic therapy help patients relearn and make hand movements, adaptive training, which introduces barriers to hand movements that stroke patients must overcome, appears to be even more effective.
The adaptive training model used in the study was developed by RIC to complement physical therapy and other rehabilitation methods used to help stroke patients recover.
"The study shows that adaptive technology is an important advance in stroke care that may hasten recovery," said lead investigator James Patton, Ph.D., co-director of the RIC Robotics Lab and research scientist. "Stroke patients may benefit more from training that makes them work to overcome their impairments, as opposed to training that guides them through movements."
The study included 27 stroke patients and four healthy controls who were asked to perform a series of robot-enhanced movements. The robotic arm was attached only to the stroke patients' impaired arms, which resulted in use of the non-dominant hand in 17 of the 27 patients. Subjects practiced a total of 834 hand movements, during which the robot either pushed to make their errors worse or better.
Results showed significant improvements in the straightness in the direction of patients' hand movements. Both stroke patients and healthy controls demonstrated a clear ability to adapt to the robot-created force field. This adaptation is most clearly seen when the forces are unexpectedly removed during training -- they saw 'after-effect' of adaptation where they curved in the opposite direction. At the end of training, ten of the 18 stroke patients demonstrated after-effects that were statistically significant from baseline (P<0.05 in individual t-tests) and as a group, stroke survivors showed a significant shift following training (P<0.05 in a paired t-test of subject averages). A striking result was that those who had their original errors amplified by the robot during training did better in the end than those who had their error reduced, and those who trained with no forces.
"I entered the study almost 12 years after my stroke," said Norm Shapiro, 76 year old study participant. "Adaptive training has helped me loosen up my arm, which still had a lot of paralysis, and trained me to overcome the weakness and lack of control. Now I can use it to do more everyday things."
About the Rehabilitation Institute of Chicago
The Rehabilitation Institute of Chicago (RIC) helps more people with stroke than almost any other hospital in the country. More than 700 patients each year come to RIC for physical medicine and rehabilitation and new developments in stroke recovery. Research has shown that healthcare providers' experience can enhance outcomes and ultimately quality of life. RIC is the only U.S. federally-designated Rehabilitation Research and Training Center for Stroke by the National Institute on Disability and Rehabilitation Research.
RIC is dedicated to helping people with all levels and types of physical disabilities regain or improve their physical functions and empowering them to participate more fully in family, social, vocational and leisure time pursuits. The Institute has been ranked the 'Best Rehabilitation Hospital in America' by U.S. News & World Report, every year since 1991 and is the first independent rehabilitation hospital in the country to receive the Magnet award for excellence in nursing services by the American Nurses Credentialing Center. For more information, please visit our Web site at www.ric.org.
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