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Titre : | Invited Commentary on Comparison of Robotics, Functional Electrical Stimulation, and Motor Learning Methods for Treatment of Persistent Upper Extremity Dysfunction After Stroke: A Randomized Controlled Trial (2015) |
Auteurs : | Gert Kwakkel ; Erwin E. van Wegen ; Carel M. Meskers |
Type de document : | Article |
Dans : | Archives of Physical Medicine and Rehabilitation (2015/6, 2015) |
Article en page(s) : | p. 991993 |
Langues: | Anglais |
Descripteurs : |
HE Vinci Accident vasculaire cérébral (AVC) ; Membre supérieur ; Rééducation et réadaptation ; Robotique |
Mots-clés: | Electric stimulation ; Stimulation électrique ; Robotics ; Stroke ; Upper extremity |
Résumé : | In this issue of Archives of Physical Medicine and Rehabilitation, Jessica McCabe and colleagues report findings from their methodologically sound, dose-matched clinical trial in 39 patients beyond 6 months poststroke. In this phase II trial, the effects of 60 treatment sessions, each involving 3.5 hours of intensive practice plus either 1.5 hours of functional electrical stimulation (FES) or a shoulder-arm robotic therapy, were compared with 5 hours of intensive daily practice alone. Although no significant between-group differences were found on the primary outcome measure of Arm Motor Ability Test and the secondary outcome measure of Fugl-Meyer Arm motor score, 10% to 15% within-group therapeutic gains were on the Arm Motor Ability Test and Fugl-Meyer Arm. These gains are clinically meaningful for patients with stroke. However, the underlying mechanisms that drive these improvements remain poorly understood. The approximately $1000 cost reduction per patient calculated for the use of motor learning (ML) methods alone or combined with FES, compared with the combination of ML and shoulder-arm robotics, further emphasizes the need for cost considerations when making clinical decisions about selecting the most appropriate therapy for the upper paretic limb in patients with chronic stroke. |
Disponible en ligne : | Oui |
En ligne : | https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/article/pii/S0003999315001112 |