- Wu, Jennifer;
- Dodakian, Lucy;
- See, Jill;
- Quinlan, Erin Burke;
- Meng, Lisa;
- Abraham, Jeby;
- Wong, Ellen C;
- Le, Vu;
- McKenzie, Alison;
- Cramer, Steven C
Background
Studies examining the effects of therapeutic interventions after stroke often focus on changes in loss of body function/structure (impairment). However, improvements in activities limitations and participation restriction are often higher patient priorities, and the relationship that these measures have with loss of body function/structure is unclear.Objective
This study measured gains across WHO International Classification of Function (ICF) dimensions and examined their interrelationships.Methods
Subjects were recruited 11 to 26 weeks after hemiparetic stroke. Over a 3-week period, subjects received 12 sessions of intensive robot-based therapy targeting the distal arm. Each subject was assessed at baseline and at 1 month after end of therapy.Results
At baseline, subjects (n = 40) were 134.7 ± 32.4 (mean ± SD) days poststroke and had moderate-severe arm motor deficits (arm motor Fugl-Meyer score of 35.6 ± 14.4) that were stable. Subjects averaged 2579 thumb movements and 1298 wrist movements per treatment session. After robot therapy, there was significant improvement in measures of body function/structure (Fugl-Meyer score) and activity limitations (Action Research Arm Test, Barthel Index, and Stroke Impact Scale-Hand), but not participation restriction (Stroke Specific Quality of Life Scale). Furthermore, while the degree of improvement in loss of body function/structure was correlated with improvement in activity limitations, neither improvement in loss of body function/structure nor improvement in activity limitations was correlated with change in participation restriction.Conclusions
After a 3-week course of robotic therapy, there was improvement in body function/structure and activity limitations but no reduction in participation restriction.