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Combined Use of Repetitive Task Practice and an Assistive Robotic Device in a Patient With Subacute Stroke

EM Frick, MS, is Resident Orthotist/Prosthetist, Department of Orthopedic Surgery & Rehabilitation, University of Oklahoma Health Sciences Center, Oklahoma City, Okla
JL Alberts, PhD, is Assistant Staff, Department of Biomedical Engineering and Center for Neurological Restoration, The Cleveland Clinic, Cleveland, OH 44195, and Functional Electrical Stimulation Center, Louis Stokes Veterans Affairs Medical Center, Cleveland, OH 44106

Address all correspondence to Dr Alberts at: albertj{at}ccf.org

Background and Purpose. This case report describes a training program comprising repetitive task practice (RTP) and robotic therapy for a patient with subacute stroke and resultant impaired upper-extremity function. Case Description. A 63-year-old man with right-sided hemiplegia resulting from a hemorrhagic stroke received a combined intervention of RTP and robotic therapy for 4 hours per day for 3 weeks. Clinical and kinetic evaluations were performed before and after intervention. Outcomes. Following the combined intervention, clinical improvements in hand function were observed, maximum grip force decreased slightly, and interlimb coupling decreased. Discussion. An intervention of RTP with robotic therapy may be an effective method to improve upper-extremity function following stroke. Furthermore, the case suggests that improvements in strength are not necessary for improved dexterous function, provided that a minimal level of strength is present.

Key Words: Forced use • Rehabilitation • Robotic therapy • Stroke • Upper extremity