Home Based Telerehabilitation (T-WREX)
Arm weakness caused by stroke can limit the ability to complete many daily tasks. A growing body of research suggests it is possible for stroke survivors to improve arm movement with intensive training. However, intense training generally requires close supervision from a therapist. Many insurance providers limit coverage for such treatment, and some stroke survivors do not have easy access to direct therapist care. The goal of this project is to develop and test a device which allows stroke survivors to practice arm movement therapy at home or in a clinic with indirect supervision. The Training-Wilmington Robotic Exoskeleton (T-WREX) was developed at the University of California-Irvine. This device was designed for adults with significant arm weakness resulting from stroke, and provides intense movement training without continuous supervision from a therapist. T-WREX is a five degree-of-freedom passive antigravity orthosis and computer workstation. The orthosis relieves the weight of the arm using elastic bands attached around its frame. It is instrumented and contains mechanical joints which correspond to joints of the human arm, allowing naturalistic arm movements. Stroke survivors are able to practice repetitive arm movements in the T-WREX by playing functionally oriented computer games such as reaching for objects on a shelf, eating, and cooking. A pilot study with five chronic stroke subjects at U.C. Irvine demonstrated that exercising the affected arm with T-WREX over an 8 week period improved unassisted movement ability.
This project is currently investigating two different approaches for upper extremity training with adult stroke survivors. One intervention involves training with the T-WREX and the other involves traditional arm exercises. This study will assist researchers in determining whether these types of exercises improve arm movement without direct supervision from a therapist.
One exercise program involves self-range
of motion, bilateral upper extremity use in
functional activities and active-assistive
The second exercise program involves
training with the T-WREX arm orthosis
and computer workstation.