Multicenter randomized trial of robot-assisted rehabilitation for chronic stroke: Methods and entry characteristics for VA ROBOTICS

Albert C. Lo, Peter Guarino, Hermano I. Krebs, Bruce T. Volpe, Christopher T. Bever, Pamela W. Duncan, Robert J. Ringer, Todd H. Wagner, Lorie G. Richards, Dawn Bravata, Jodie K. Haselkorn, George F. Wittenberg, Daniel G. Federman, Barbara H. Corn, Alysia D. Maffucci, Peter Peduzzi

Research output: Contribution to journalArticle

53 Citations (Scopus)

Abstract

Background. Chronic upper extremity impairment due to stroke hasificant medical, psychosocial, and financial consequences, but few studies have examined the effectiveness of rehabilitation therapy during the chronic stroke period. Objective. To test the safety and efficacy of the MIT-Manus robotic device for chronic upper extremity impairment following stroke. Methods. The VA Cooperative Studies Program initiated a multicenter, randomized, controlled trial in November 2006 (VA ROBOTICS). Participants with upper extremity impairment ĝ‰¥6 months poststroke were randomized to robot-assisted therapy (RT), intensive comparison therapy (ICT), or usual care (UC). RT and ICT consisted of three 1-hour treatment sessions per week for 12 weeks. The primary outcome was change in the Fugl-Meyer Assessment upper extremity motor function score at 12 weeks relative to baseline. Secondary outcomes included the Wolf Motor Function Test and the Stroke Impact Scale. Results. A total of 127 participants were randomized: 49 to RT, 50 to ICT, and 28 to UC. The majority of participants were male (96%), with a mean age of 65 years. The primary stroke type was ischemic (85%), and 58% of strokes occurred in the anterior circulation. Twenty percent of the participants reported a stroke in addition to their index stroke. The average time from the index stroke to enrollment was 56 months (range, 6 months to 24 years). The mean Fugl-Meyer score at entry was 18.9. Conclusions. VA ROBOTICS demonstrates the feasibility of conducting multicenter clinical trials to rigorously test new rehabilitative devices before their introduction to clinical practice. The results are expected in early 2010.

Original languageEnglish (US)
Pages (from-to)775-783
Number of pages9
JournalNeurorehabilitation and Neural Repair
Volume23
Issue number8
DOIs
StatePublished - Oct 2009
Externally publishedYes

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Multicenter Studies
Stroke
Upper Extremity
Therapeutics
Stroke Rehabilitation
Equipment and Supplies
Robotics
Rehabilitation
Randomized Controlled Trials
Clinical Trials
Safety

Keywords

  • Health economics
  • Randomized clinical trial
  • Rehabilitation
  • Robotics
  • Stroke

ASJC Scopus subject areas

  • Clinical Neurology
  • Rehabilitation
  • Neurology

Cite this

Multicenter randomized trial of robot-assisted rehabilitation for chronic stroke : Methods and entry characteristics for VA ROBOTICS. / Lo, Albert C.; Guarino, Peter; Krebs, Hermano I.; Volpe, Bruce T.; Bever, Christopher T.; Duncan, Pamela W.; Ringer, Robert J.; Wagner, Todd H.; Richards, Lorie G.; Bravata, Dawn; Haselkorn, Jodie K.; Wittenberg, George F.; Federman, Daniel G.; Corn, Barbara H.; Maffucci, Alysia D.; Peduzzi, Peter.

In: Neurorehabilitation and Neural Repair, Vol. 23, No. 8, 10.2009, p. 775-783.

Research output: Contribution to journalArticle

Lo, AC, Guarino, P, Krebs, HI, Volpe, BT, Bever, CT, Duncan, PW, Ringer, RJ, Wagner, TH, Richards, LG, Bravata, D, Haselkorn, JK, Wittenberg, GF, Federman, DG, Corn, BH, Maffucci, AD & Peduzzi, P 2009, 'Multicenter randomized trial of robot-assisted rehabilitation for chronic stroke: Methods and entry characteristics for VA ROBOTICS', Neurorehabilitation and Neural Repair, vol. 23, no. 8, pp. 775-783. https://doi.org/10.1177/1545968309338195
Lo, Albert C. ; Guarino, Peter ; Krebs, Hermano I. ; Volpe, Bruce T. ; Bever, Christopher T. ; Duncan, Pamela W. ; Ringer, Robert J. ; Wagner, Todd H. ; Richards, Lorie G. ; Bravata, Dawn ; Haselkorn, Jodie K. ; Wittenberg, George F. ; Federman, Daniel G. ; Corn, Barbara H. ; Maffucci, Alysia D. ; Peduzzi, Peter. / Multicenter randomized trial of robot-assisted rehabilitation for chronic stroke : Methods and entry characteristics for VA ROBOTICS. In: Neurorehabilitation and Neural Repair. 2009 ; Vol. 23, No. 8. pp. 775-783.
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title = "Multicenter randomized trial of robot-assisted rehabilitation for chronic stroke: Methods and entry characteristics for VA ROBOTICS",
abstract = "Background. Chronic upper extremity impairment due to stroke hasificant medical, psychosocial, and financial consequences, but few studies have examined the effectiveness of rehabilitation therapy during the chronic stroke period. Objective. To test the safety and efficacy of the MIT-Manus robotic device for chronic upper extremity impairment following stroke. Methods. The VA Cooperative Studies Program initiated a multicenter, randomized, controlled trial in November 2006 (VA ROBOTICS). Participants with upper extremity impairment ĝ‰¥6 months poststroke were randomized to robot-assisted therapy (RT), intensive comparison therapy (ICT), or usual care (UC). RT and ICT consisted of three 1-hour treatment sessions per week for 12 weeks. The primary outcome was change in the Fugl-Meyer Assessment upper extremity motor function score at 12 weeks relative to baseline. Secondary outcomes included the Wolf Motor Function Test and the Stroke Impact Scale. Results. A total of 127 participants were randomized: 49 to RT, 50 to ICT, and 28 to UC. The majority of participants were male (96{\%}), with a mean age of 65 years. The primary stroke type was ischemic (85{\%}), and 58{\%} of strokes occurred in the anterior circulation. Twenty percent of the participants reported a stroke in addition to their index stroke. The average time from the index stroke to enrollment was 56 months (range, 6 months to 24 years). The mean Fugl-Meyer score at entry was 18.9. Conclusions. VA ROBOTICS demonstrates the feasibility of conducting multicenter clinical trials to rigorously test new rehabilitative devices before their introduction to clinical practice. The results are expected in early 2010.",
keywords = "Health economics, Randomized clinical trial, Rehabilitation, Robotics, Stroke",
author = "Lo, {Albert C.} and Peter Guarino and Krebs, {Hermano I.} and Volpe, {Bruce T.} and Bever, {Christopher T.} and Duncan, {Pamela W.} and Ringer, {Robert J.} and Wagner, {Todd H.} and Richards, {Lorie G.} and Dawn Bravata and Haselkorn, {Jodie K.} and Wittenberg, {George F.} and Federman, {Daniel G.} and Corn, {Barbara H.} and Maffucci, {Alysia D.} and Peter Peduzzi",
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T1 - Multicenter randomized trial of robot-assisted rehabilitation for chronic stroke

T2 - Methods and entry characteristics for VA ROBOTICS

AU - Lo, Albert C.

AU - Guarino, Peter

AU - Krebs, Hermano I.

AU - Volpe, Bruce T.

AU - Bever, Christopher T.

AU - Duncan, Pamela W.

AU - Ringer, Robert J.

AU - Wagner, Todd H.

AU - Richards, Lorie G.

AU - Bravata, Dawn

AU - Haselkorn, Jodie K.

AU - Wittenberg, George F.

AU - Federman, Daniel G.

AU - Corn, Barbara H.

AU - Maffucci, Alysia D.

AU - Peduzzi, Peter

PY - 2009/10

Y1 - 2009/10

N2 - Background. Chronic upper extremity impairment due to stroke hasificant medical, psychosocial, and financial consequences, but few studies have examined the effectiveness of rehabilitation therapy during the chronic stroke period. Objective. To test the safety and efficacy of the MIT-Manus robotic device for chronic upper extremity impairment following stroke. Methods. The VA Cooperative Studies Program initiated a multicenter, randomized, controlled trial in November 2006 (VA ROBOTICS). Participants with upper extremity impairment ĝ‰¥6 months poststroke were randomized to robot-assisted therapy (RT), intensive comparison therapy (ICT), or usual care (UC). RT and ICT consisted of three 1-hour treatment sessions per week for 12 weeks. The primary outcome was change in the Fugl-Meyer Assessment upper extremity motor function score at 12 weeks relative to baseline. Secondary outcomes included the Wolf Motor Function Test and the Stroke Impact Scale. Results. A total of 127 participants were randomized: 49 to RT, 50 to ICT, and 28 to UC. The majority of participants were male (96%), with a mean age of 65 years. The primary stroke type was ischemic (85%), and 58% of strokes occurred in the anterior circulation. Twenty percent of the participants reported a stroke in addition to their index stroke. The average time from the index stroke to enrollment was 56 months (range, 6 months to 24 years). The mean Fugl-Meyer score at entry was 18.9. Conclusions. VA ROBOTICS demonstrates the feasibility of conducting multicenter clinical trials to rigorously test new rehabilitative devices before their introduction to clinical practice. The results are expected in early 2010.

AB - Background. Chronic upper extremity impairment due to stroke hasificant medical, psychosocial, and financial consequences, but few studies have examined the effectiveness of rehabilitation therapy during the chronic stroke period. Objective. To test the safety and efficacy of the MIT-Manus robotic device for chronic upper extremity impairment following stroke. Methods. The VA Cooperative Studies Program initiated a multicenter, randomized, controlled trial in November 2006 (VA ROBOTICS). Participants with upper extremity impairment ĝ‰¥6 months poststroke were randomized to robot-assisted therapy (RT), intensive comparison therapy (ICT), or usual care (UC). RT and ICT consisted of three 1-hour treatment sessions per week for 12 weeks. The primary outcome was change in the Fugl-Meyer Assessment upper extremity motor function score at 12 weeks relative to baseline. Secondary outcomes included the Wolf Motor Function Test and the Stroke Impact Scale. Results. A total of 127 participants were randomized: 49 to RT, 50 to ICT, and 28 to UC. The majority of participants were male (96%), with a mean age of 65 years. The primary stroke type was ischemic (85%), and 58% of strokes occurred in the anterior circulation. Twenty percent of the participants reported a stroke in addition to their index stroke. The average time from the index stroke to enrollment was 56 months (range, 6 months to 24 years). The mean Fugl-Meyer score at entry was 18.9. Conclusions. VA ROBOTICS demonstrates the feasibility of conducting multicenter clinical trials to rigorously test new rehabilitative devices before their introduction to clinical practice. The results are expected in early 2010.

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KW - Randomized clinical trial

KW - Rehabilitation

KW - Robotics

KW - Stroke

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