Study Shows Robotic Therapy May Have Advantages Over Treatment by Human Physical Therapists
By Charlene Laino
WebMD Health News
Reviewed by Laura J. Martin, MD
Latest Neurology News
Feb. 11, 2011 (Los Angeles) -- Robot-assisted therapy can help improve arm and shoulder mobility in people left paralyzed after a stroke.
In a study of 56 stroke survivors with paralysis on one side of the body, those who underwent robotic therapy improved more on a test of arm and shoulder motor function than those who received more standard rehab.
"We hypothesize that robots, [unlike human physical therapists], can help people to carry out repetitive exercises with the same movements every time, thereby re-educating the brain," says Kayoko Takahashi, ScD, clinician and research associate in the department of occupational therapy in Kitasato University East Hospital in Kanagawa, Japan.
The study was presented at the American Stroke Association's International Stroke Conference 2011.
Robots vs. Therapists
The study involved people who had suffered a stroke in the previous four to eight weeks. All received 40 minutes of standard rehabilitation therapy daily from an occupational therapist.
Thirty-two patients also received robotic therapy using the Reo Therapy System in 40-minute sessions every day for six weeks. The patient's forearm is placed on a platform sticking out from the robot and a stick is used to repeatedly guide the forearm in various pre-programmed directions.
The other participants spent the same amount of time working through a standard self-training exercise program designed to teach stroke survivors how to change their clothes and perform other daily activities.
Improvements in Motor Function
Here are the results from the training sessions, as measured on the 36-point Fugl-Meyer shoulder/elbow/forearm scale. Higher numbers reflect better motor function:
- Patients in the robot group improved 5 points, from an average of 19 points to 24 points.
- Patients in the standard therapy group improved 2 points, from 22 to 24 points.
- No patients complained of any side effects from the robotic therapy.
The Israeli-based company that makes the system could not be reached for comment on its cost. But Robert J. Adams, MD, director of the Medical University of South Carolina Stroke Center in Charleston, tells WebMD that if robot-assisted therapy can replace standard rehab, he "envisions that it could end up being cost-effective. One-on-one rehab with an occupational therapist is inefficient and not well paid for."
However, this study shows only that it is useful in conjunction with standard rehab, not in place of it.
Many questions remain, Adams says. "For example, why do it four to eight weeks after the stroke? Why in 40-minute sessions? And how long does the effect last? These are all things we don't know."
The study was in funded in part by Teijin Pharma Limited, which makes the robotic system in Japan.
These findings were presented at a medical conference. They should be considered preliminary as they have not yet undergone the "peer review" process, in which outside experts scrutinize the data prior to publication in a medical journal.
SOURCES: American Stroke Association International Stroke Conference 2011, Los Angeles, Feb. 7-11, 2011.Kayoko Takahashi, ScD, clinician and research associate, department of occupational therapy, Kitasato University East Hospital, Kanagawa, Japan.Robert J. Adams, MD, director, Medical University of South Carolina Stroke Center, Charleston.
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