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3198893 
Journal Article 
Combined Clinic-Home Approach for Upper Limb Robotic Therapy After Stroke: A Pilot Study 
Kim, GJ; Rivera, L; Stein, J 
2015 
Yes 
Archives of Physical Medicine and Rehabilitation
ISSN: 0003-9993
EISSN: 1532-821X 
96 
12 
2243-2248 
English 
26189202 
OBJECTIVE: To investigate the feasibility of a combined clinic-home intervention using a robotic elbow brace and, secondarily, to collect preliminary data on the efficacy of this clinic-home intervention.

DESIGN: Nonrandomized pre-/postinterventional study.

SETTING: Outpatient clinic and participants' homes.

PARTICIPANTS: Individuals at least 6 months after stroke (N=11; 5 women and 6 men; mean age, 51.7y; mean time since stroke, 7.6y; mean Fugl-Meyer Assessment of the Upper Extremity [FMA-UE] score, 22 of 66) were enrolled from the community.

INTERVENTIONS: Participants received training in an outpatient clinic from an experienced occupational therapist to gain independence with use of the device (3-9 sessions) followed by a 6-week home program using the device at home.

MAIN OUTCOME MEASURES: Five instruments were administered before and after the study intervention: Modified Ashworth Scale, Box and Blocks test, FMA-UE, Arm Motor Ability Test, and Motor Activity Log-Amount of Use and Motor Activity Log-How Well subscales (MAL-AOU, MAL-HW).

RESULTS: Nine participants completed the study. Participants used the device on average 42.9min/d, 5.3d/wk. The FMA-UE (t=3.32; P=.01), MAL-AOU (t=4.40; P=.002), and MAL-HW (t=4.02; P=.004) scores showed statistically significant improvement from baseline to discharge; the MAL-AOU (t=2.61; P=.035) and MAL-HW (t=2.47; P=.043) scores were also significantly improved from baseline to 3-month follow-up.

CONCLUSIONS: This combined clinic-home intervention was feasible and effective. Participants demonstrated improvements in arm impairment and self-reported use of the arm from baseline to discharge; they continued to report significant improvement in actual use of the arm at 3-month follow-up.