Extension of the MIME Robotic System for Stroke Rehabilitation
| Status: | Completed |
|---|---|
| Conditions: | Neurology |
| Therapuetic Areas: | Neurology |
| Healthy: | No |
| Age Range: | 21 - 90 |
| Updated: | 9/22/2018 |
| Start Date: | June 2010 |
| End Date: | May 2012 |
The goal of this project is to develop and test a new robotic system to accommodate practice
of tasks requiring reach, grasp and release of objects. Our previous work has shown that the
MIME robot is safe and effective for improving reach in stroke subjects. But adequate control
of hand movements is critical to a functional upper limb, and is often resistant to
conventional therapeutic interventions. Many stroke survivors have residual ability to flex
the fingers, but extension is often limited and impeded by increased passive stiffness in
flexors, abnormal levels of increased tone in flexors and weakness in extensors. In a recent
study, 38% of stroke survivors reported that impaired hand function was the most disabling
motor impairment they faced.
of tasks requiring reach, grasp and release of objects. Our previous work has shown that the
MIME robot is safe and effective for improving reach in stroke subjects. But adequate control
of hand movements is critical to a functional upper limb, and is often resistant to
conventional therapeutic interventions. Many stroke survivors have residual ability to flex
the fingers, but extension is often limited and impeded by increased passive stiffness in
flexors, abnormal levels of increased tone in flexors and weakness in extensors. In a recent
study, 38% of stroke survivors reported that impaired hand function was the most disabling
motor impairment they faced.
Research Design:
We hypothesize that: 1) Gains in proximal arm function (shoulder, elbow) immediately after
robotic training will be greater than after dose-matched conventional therapy; 2) Unlike in
previous studies, gains in hand function immediately after robotic training will be greater
than after dose-matched conventional therapy.
Methodology:
In the first year of the study, we will develop a robotic system with the ability to assist
hand movement. Since many stroke survivors in the subacute and chronic recovery stages have
residual ability to flex the fingers but severely limited finger extension, we will build a
hand exoskeleton that can apply precise extension forces to the digits of the hand. This
exoskeleton will be integrated with the ARMin III arm exoskeleton so that tasks such as arm
reach, grasp of an object and release of the object can be trained. In the last 2 years of
the project, we will perform a pilot clinical trial comparing this new training paradigm to
dose-matched conventional therapy in chronic stroke survivors. Outcome measures will be taken
before training and immediately after training.
We hypothesize that: 1) Gains in proximal arm function (shoulder, elbow) immediately after
robotic training will be greater than after dose-matched conventional therapy; 2) Unlike in
previous studies, gains in hand function immediately after robotic training will be greater
than after dose-matched conventional therapy.
Methodology:
In the first year of the study, we will develop a robotic system with the ability to assist
hand movement. Since many stroke survivors in the subacute and chronic recovery stages have
residual ability to flex the fingers but severely limited finger extension, we will build a
hand exoskeleton that can apply precise extension forces to the digits of the hand. This
exoskeleton will be integrated with the ARMin III arm exoskeleton so that tasks such as arm
reach, grasp of an object and release of the object can be trained. In the last 2 years of
the project, we will perform a pilot clinical trial comparing this new training paradigm to
dose-matched conventional therapy in chronic stroke survivors. Outcome measures will be taken
before training and immediately after training.
Inclusion Criteria:
- An ischemic or hemorrhagic stroke more than 6 months prior to entry into the study;
- trace ability to move the wrist and fingers in extension;
- voluntary shoulder elevation to approximately 45 deg;
- be between the ages of 21 and 90.
Exclusion Criteria:
- Have cognitive deficits that could negatively affect their ability to complete
protocols as evidenced by a score of 24 or less on the Folstein Mini - Mental State
Examination (Bleeker, 1988);
- have excessive pain in any joint of the affected extremity that could limit ability to
cooperate with the protocols;
- have an upper extremity injury or conditions prior to stroke that could limit
participation;
- have severe hemispatial neglect.
- have a full score of 24 on the distal section of the Fugl-Myer test (FM) (Fugl-Meyer
1975); and
- have severe sensory loss.
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