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document
Effect of gravity on robot-assisted motor training after chronic stroke : a randomized trial . OBJECTIVES To determine the efficacy of 2 distinct 6-week robot-assisted reaching programs compared with an intensive conventional arm exercise program ( ICAE ) for chronic , stroke-related upper-extremity ( UE ) impairment . To examine whether the addition of robot-assisted training out of the horizontal plane leads to improved outcomes . DESIGN Randomized controlled trial , single-blinded , with 12-week follow-up . SETTING Research setting in a large medical center . PARTICIPANTS Adults ( N=62 ) with chronic , stroke-related arm weakness stratified by impairment severity using baseline UE motor assessments . INTERVENTIONS Sixty minutes , 3 times a week for 6 weeks of robot-assisted planar reaching ( gravity compensated ) , combined planar with vertical robot-assisted reaching , or intensive conventional arm exercise program . MAIN OUTCOME MEASURE UE Fugl-Meyer Assessment ( FMA ) mean change from baseline to final training . RESULTS All groups showed modest gains in the FMA from baseline to final with no significant between group differences . Most change occurred in the planar robot group ( mean change ± SD , 2.94 ± 0.77 ; 95 % confidence interval [ CI ] , 1.40-4.47 ) . Participants with greater motor impairment ( n=41 ) demonstrated a larger difference in response ( mean change ± SD , 2.29 ± 0.72 ; 95 % CI , 0.85-3.72 ) for planar robot-assisted exercise compared with the intensive conventional arm exercise program ( mean change ± SD , 0.43 ± 0.72 ; 95 % CI , -1.00 to 1.86 ) . CONCLUSIONS Chronic UE deficits because of stroke are responsive to intensive motor task training . However , training outside the horizontal plane in a gravity present environment using a combination of vertical with planar robots was not superior to training with the planar robot alone .
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Intervention_Other
robot-assisted motor training
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Intervention_Other
robot-assisted reaching programs
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Intervention_Other
conventional arm exercise program
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Intervention_Other
robot-assisted training
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Intervention_Other
robot-assisted planar reaching ( gravity compensated )
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Intervention_Other
combined planar with vertical robot-assisted reaching
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Intervention_Other
intensive conventional arm exercise program
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Outcome_Physical
chronic stroke
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Outcome_Physical
chronic , stroke-related upper-extremity ( UE )
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Outcome_Physical
UE Fugl-Meyer Assessment ( FMA ) mean change
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Outcome_Other
modest gains in the
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Outcome_Physical
FMA
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Participant_Condition
chronic stroke
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Participant_Age
Adults
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Participant_Sample-size
N=62
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Participant_Condition
chronic , stroke-related arm weakness
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Participant_Condition
impairment