Predictors of motor, daily function, and quality-of-life improvements after upper-extremity robot-assisted rehabilitation in stroke

Pai-Chuan Huang; Yu-Wei Hsieh; Chin-Man Wang; Ching-Yi Wu; Shu-Chun Huang; Keh-Chung Lin

doi:10.5014/ajot.2014.010546

Predictors of motor, daily function, and quality-of-life improvements after upper-extremity robot-assisted rehabilitation in stroke

Am J Occup Ther. 2014 May-Jun;68(3):325-33. doi: 10.5014/ajot.2014.010546.

Authors

Pai-Chuan Huang¹, Yu-Wei Hsieh², Chin-Man Wang³, Ching-Yi Wu⁴, Shu-Chun Huang⁵, Keh-Chung Lin⁶

Affiliations

¹ Pai-Chuan Huang, ScD, OTR/L, is Postdoctoral Fellow, Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan, and Healthy Aging Research Center at Chang Gung University, Taoyuan, Taiwan.
² Yu-Wei Hsieh, PhD, is Assistant Professor, Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan, and Healthy Aging Research Center at Chang Gung University, Taoyuan, Taiwan.
³ Chin-Man Wang, MD, is Attending Physician, Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Linkou, Taiwan.
⁴ Ching-Yi Wu, ScD, OTR/L, is Professor and Chair, Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan, and Healthy Aging Research Center at Chang Gung University, Taoyuan, Taiwan.
⁵ Shu-Chun Huang, MD, is Attending Physician, Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Linkou, Taiwan.
⁶ Keh-Chung Lin, ScD, OTR/L, is Professor, School of Occupational Therapy, College of Medicine, National Taiwan University and Division of Occupational Therapy, Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, 17, F4, Xu Zhou Road, Taipei, Taiwan; kehchunglin@ntu.edu.tw.

PMID: 24797196
DOI: 10.5014/ajot.2014.010546

Abstract

Objective: A subgroup of patients benefiting most from robot-assisted therapy (RT) has not yet been described. We examined the predictors of improved outcomes after RT.

Method: Sixty-six patients with stroke receiving RT were analyzed. The outcome measures were the Fugl-Meyer Assessment (FMA), Wolf Motor Function Test (WMFT), Motor Activity Log (MAL), and Stroke Impact Scale (SIS). The potential predictors were age, side of lesion, time since onset, Modified Ashworth Scale (MAS) scores, accelerometer data, Box and Block Test (BBT) scores, and kinematic parameters.

Results: BBT scores were predictive of FMA (29%) and MAL (9%-15%) improvements. Reduced shoulder flexion synergy, as measured by less shoulder abduction during forward reach, and MAS-distal were predictive of WMFT-function improvements. MAS-distal was predictive of SIS-physical improvements. Demographic variables did not predict outcomes.

Conclusion: Manual dexterity was a valuable predictor of motor impairment and daily function after RT. Outcomes at different levels may have different predictors.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Cohort Studies
Female
Humans
Male
Middle Aged
Motor Skills / physiology
Outcome Assessment, Health Care
Quality of Life*
Regression Analysis
Robotics*
Stroke / physiopathology
Stroke Rehabilitation*
Upper Extremity*