“Robot-assisted Therapy for Long-Term Upper-Limb
Impairment After Stroke”
FREQUENTLY ASKED QUESTIONS:
Why is this research so important?
“We’ve shown that with the right therapy, [stroke patients] can see improvements in movement, everyday function and quality of life – this is giving stroke survivors new hope,”
says Dr. Albert Lo, Principal Investigator. The implications for stroke recovery and study design were so powerful that this was the first article published in the prestigious NEJM on the topic of rehabilitation.
Why were InMotion™ Robots selected for this study?
The unique assist-as-needed™ exercise delivered by InMotion Robots [company: Bionik] is the optimal way to drive recovery through neuro-plastic remapping of sensory-motor pathways. InMotion’s interactive robots actively engage neurologically injured patients in repetitive tasks that reinforce normal movement patterns and improve everyday function, even years post injury.
Is InMotion interactive assist-as-needed™ therapy an established practice?
Yes, many leading rehabilitation hospitals in the U.S. and abroad are using InMotion Robots everyday to improve arm function following stroke, brain injury and other neurological diagnoses. The NEJM article, the 1A level of evidence endorsement of the AHA*, and over 18 years of prior research provide a large evidence base supporting treatment effectiveness.
What treatment methods were compared?
Patients were randomly assigned to three study groups:
- Usual care
- InMotion robot-assisted therapy and
- Intensity-matched treatment delivered by a therapist.
Patients in both the robot-assisted and the intensity -matched treatment group received 1024 exercise repetitions per session, a level of intensity that is only practical with robot assistance.
Are the results universally applicable?
Yes. The study enrolled sixty -five percent (65%) of interested Veterans. Only those with mild impairments due to stroke, or those unable to travel for the duration of study were excluded.
This study involved patients with severe impairment, and many had only trace shoulder movement (Fugl -Meyer Assessment Score (FMA) ranging 7 to 38 out of a possible 66 points.) About 1/3 had multiple strokes. Average time post onset was 4.7 years. Finally, most were too severe to be candidates for modified constraint-induced therapy.
Did the robotic group show superior outcomes?
Yes, after the 36 week study period the robot-assisted group out-performed the usual care groups.
The robot-assisted therapy group Fugl -Meyer Assessment Score (FMA) gain was 5 points greater than the usual care group. And, a significant number of robot-assisted
participants showed much higher FMA gains ranging above 6 points.
“Usual Care” was not typical care
Robot-assisted care was superior despite the fact that “usual care” in the VA study averaged 3 hours of upper limb therapy per week. By contrast, the large majority of patients in third party payer settings receive little if any rehabilitation beyond the first year post-stroke.
Is robotic therapy cost effective?
Yes, the TOTAL cost to the VA was roughly the same between the usual care and the robot-assisted therapy group. Despite the cost of robotic equipment, the robot-assisted group experiences significant reduction in cost and use of other medical services compared to the usual care group.