Robotic Mirror Therapy System for Functional Recovery of Hemiplegic Arms
Study Details
Study Description
Brief Summary
The investigators developed a real-time 2-axis mirror robot system as a simple add-on module for conventional mirror therapy using a closed feedback mechanism, which allows for real-time movement of the hemiplegic arm. The investigators conduct a case study for stroke patients with a two-dimensional mirror robot for 30 min per day for two weeks (10 sessions). For the conventional mirror therapy group, the investigators prepared the tasks for fine motor training.
Condition or Disease | Intervention/Treatment | Phase |
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N/A |
Detailed Description
The investigators conduct a case study for stroke patients with a two-dimensional mirror robot for 30 min per day for two weeks (10 sessions). For the conventional mirror therapy group, the investigators prepared the tasks for fine motor training. These tasks included more complicated tasks so that the participants would be interested in the tasks without the robot system.
Before and after 10 sessions of the therapy, the investigators conduct functional evaluations: the Fugl-Meyer assessment scale of the upper extremity (FMA-UE), the modified Ashworth scale, the modified Barthel index of upper extremity (MBI-UE: personal hygiene, bathing, feeding, and dressing), and the Jebsen hand function test, hand power measurement, and hemispatial neglect test (line bisection test and Albert's test) with the same occupational therapist. The motor evoked potential was measured for the patients without the history of brain surgery or seizure.
The investigators selected a thumb finding test (TFT) among various tools for assessing proprioception, because TFT is widely used and reliable. The TFT can be assessed, after confirming normal proprioception in the unaffected arm, by the patient touching the nose with their eyes closed while the examiner lifts the affected arm to eye level. The patient is then asked to grasp the thumb of the affected hand with the unaffected hand, and this is repeated. The examiner then places a hand over the patient's eyes and raises the patient's affected hand to well above the patient's head. The patient is then asked to grasp the thumb as before.
Study Design
Arms and Interventions
Arm | Intervention/Treatment |
---|---|
Experimental: Robotic mirror therapy For 30 min per day for two weeks (10 sessions) |
Device: Robotic mirror therapy
2-dimensional
|
Active Comparator: Conventional mirror therapy For 30 min per day for two weeks (10 sessions) |
Device: Conventional mirror therapy
2- and 3-dimensional
|
Outcome Measures
Primary Outcome Measures
- Fugl-Meyer assessment scale [Change from baseline data at 2 weeks]
Secondary Outcome Measures
- Thumb finding test [Before treatment, after 2 weeks, after 2 months]
- Modified Ashworth scale [Before treatment, after 2 weeks, after 2 months]
- Modified Barthel index [Before treatment, after 2 weeks, after 2 months]
- Hand power(lb) assessed by dynamometer [Before treatment, after 2 weeks, after 2 months]
- Jebsen hand function test [Before treatment, after 2 weeks, after 2 months]
- Hemispatial neglect test [Before treatment, after 2 weeks, after 2 months]
- Functional brain MRI [Before treatment, after 2 weeks]
- Fugl-Meyer assessment scale [after 2 months]
Eligibility Criteria
Criteria
Inclusion Criteria:
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Over 18 years old
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Supratentorial stroke diagnosed between 4 months and 6 years ago
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Upper-limb hemiplegia with Medical Research Council grade 2 or less.
Exclusion Criteria:
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Severe spasticity with modified Ashworth scale of grade 3 or more;
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Mini-mental state examination score less than 12
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Global or sensory aphasia.
Contacts and Locations
Locations
Site | City | State | Country | Postal Code | |
---|---|---|---|---|---|
1 | Seoul National University Hospital | Seoul | Korea, Republic of |
Sponsors and Collaborators
- Seoul National University Hospital
- Seoul National University
Investigators
None specified.Study Documents (Full-Text)
None provided.More Information
Publications
- Bhasin A, Padma Srivastava MV, Kumaran SS, Bhatia R, Mohanty S. Neural interface of mirror therapy in chronic stroke patients: a functional magnetic resonance imaging study. Neurol India. 2012 Nov-Dec;60(6):570-6. doi: 10.4103/0028-3886.105188.
- Dohle C, Püllen J, Nakaten A, Küst J, Rietz C, Karbe H. Mirror therapy promotes recovery from severe hemiparesis: a randomized controlled trial. Neurorehabil Neural Repair. 2009 Mar-Apr;23(3):209-17. doi: 10.1177/1545968308324786. Epub 2008 Dec 12.
- Hamzei F, Läppchen CH, Glauche V, Mader I, Rijntjes M, Weiller C. Functional plasticity induced by mirror training: the mirror as the element connecting both hands to one hemisphere. Neurorehabil Neural Repair. 2012 Jun;26(5):484-96. doi: 10.1177/1545968311427917. Epub 2012 Jan 13.
- Pandian JD, Arora R, Kaur P, Sharma D, Vishwambaran DK, Arima H. Mirror therapy in unilateral neglect after stroke (MUST trial): a randomized controlled trial. Neurology. 2014 Sep 9;83(11):1012-7. doi: 10.1212/WNL.0000000000000773. Epub 2014 Aug 8.
- Thieme H, Bayn M, Wurg M, Zange C, Pohl M, Behrens J. Mirror therapy for patients with severe arm paresis after stroke--a randomized controlled trial. Clin Rehabil. 2013 Apr;27(4):314-24. doi: 10.1177/0269215512455651. Epub 2012 Sep 7.
- SNUH-1209-051-425