Dose and staffing comparison study of upper limb device-assisted therapy

• Published in: NeuroRehabilitation (Reading, Mass.) Vol. 46; no. 3; pp. 287 - 297
• Main Authors: Wuennemann, Marissa J, Mackenzie, Stuart W, Lane, Heather Pepper, Peltz, Avrielle R, Ma, Xiaoyue, Gerber, Linda M, Edwards, Dylan J, Kitago, Tomoko
• Format: Journal Article
• Language: English
• Published: Netherlands IOS Press BV 01.01.2020
• Subjects: Clinical outcomes; Group therapy; Neurological disorders; Orthopedic apparatus; Paralysis; Paresis; Physical therapy; Recovery (Medical); Rehabilitation; Workforce planning; group therapy; Device-assisted therapy; chronic hemiparesis; neurological rehabilitation; motor recovery
• ISSN: 1053-8135; 1878-6448
• DOI: 10.3233/NRE-192993

Neurological injuries cause persistent upper extremity motor deficits. Device-assisted therapy is an emerging trend in neuro-rehabilitation as it offers high intensity, repetitive practice in a standardized setting. To investigate the effects of therapy duration and staff-participant configuration on device-assisted upper limb therapy outcomes in individuals with chronic paresis. Forty-seven participants with chronic upper extremity weakness due to neurological injury were assigned to a therapy duration (30 or 60 min) and a staff-participant configuration (1-to-1 or 1-to-2). Therapy consisted of 3 sessions a week for 6 weeks using the Armeo®Spring device. Clinical assessments were performed at three timepoints (Pre, Post, and 3 month Follow up). Improvements in upper limb impairment, measured by change in Fugl-Meyer score (FM), were observed following therapy in all groups. FM improvement was comparable between 30 and 60 min sessions, but participants in the 1-to-2 group had significantly greater improvement in FM from Pre-to-Post and from Pre-to-Follow up than the 1-to-1 group. Device-assisted therapy can reduce upper limb impairment to a similar degree whether participants received 30 or 60 min per session. Our results suggest that delivering therapy in a 1-to-2 configuration is a feasible and more effective approach than traditional 1-to-1 staffing.