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PROJECT DESCRIPTION:
The overall goal of the study is to determine whether intensive, over-ground gait training using a novel dynamic body-weight support system leads to greater improvements in walking ability than conventional physical therapy in individuals with acute stroke. |
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The subject sample consists of sixty individuals with acute stroke. Subjects are randomly assigned to one of two groups. Group (1) receives two hours of conventional physical therapy, one hour performed by their primary physical therapist as part of their normal inpatient physical therapy program (Conventional physical therapy consist of; leg strengthening, balance, neuro muscular reeducation and gait training based on their individual impairments while working towards weekly task-specific goals) and a second hour per day performed by a research physical therapist for gait-specific therapy. Group(2) receives one hour of conventional physical therapy as described above with an additional hour per day of gait training on the ZeroG dynamic body-weight support system with a research physical therapist. ZeroG is a new over-ground body-weight support system that allows individuals with gait disorders to practice walking over smooth or uneven surfaces, up and down stairs, and around curved walkways in a safe, controlled manner. All subjects are trained 5 days per week for 2 weeks while they are inpatients at the National Rehabilitation Hospital. |
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Improvements in walking ability and lower limb motor function are evaluated at weeks 0, 2, and 14 and include the speed, level of walking assistance, endurance, balance, motor function, functional ambulation, and spasticity. Using these criteria, we will determine whether adding ZeroG gait training to in-patient therapeutic programs facilitates the recovery of stable walking patterns in acute stroke beyond the gains experienced using conventional gait training intervention. |
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| PERSONNEL |
J. Hidler, K. Brady, D. Nichols, S. Ryerson, C. Hosler-Smyth |
| FUNDING SOURCE |
NIDRR and TATRC: USAMRMC |
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Development of a hand therapeutic robotic device
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PROJECT DESCRIPTION:
Hemiparetic individuals have great difficulty controlling wrist and hand movements. These impairments can hinder one?s able to perform many typical activities of daily life. This project encompasses the design, development and clinical testing of a robotic exoskeleton for hand therapy. With novel therapy modes, this exoskeleton will help patients increase range of motion, grip strength and overall fine motor control of the hand. Many therapy modes will be investigated to determine an optimal rehabilitation strategy. Potential therapy methods include EMG control and force control. To enhance patient motivation and participation, virtual reality therapy games will be incorporated into therapy sessions. Not only will this exoskeleton be able to provide therapy, it will also serve as an assessment tool. Force and motion sensors will track the progress of each patient's recovery throughout the therapy session. With this exoskeleton, we hope to not only increase hand therapy benefits, but also to collect and analyze quantitative data to gain further incite into this debilitating impairment.
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| PERSONNEL |
C. Schabowsky and P. Lum |
| FUNDING SOURCE |
USAMRMC |
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ARMin: upper extremity robotic therapy
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PROJECT DESCRIPTION:
The overall goal of the study is to measure the effectiveness of the ARMin III robot for movement therapy following stroke. The ARMin III robot was developed by Dr. Robert Riener and Dr. Tobias Nef at the ETH in Zürich and is one of the most advanced arm robots available today. It has 6 active degrees-of-freedom, which will allow for practice of a wide range of realistic arm movements in even severely impaired subjects. The ARMin has undergone pilot clinical testing in brain injured subjects, and has several modes of passive and active assisted movement. It also provides a virtual environment to motivate the exercises in the form of simple games or ADL tasks. |
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Currently, work is focusing on refining the training modes available on the ARMin to maximize potential motor learning. Following completion of this work, a clinical trial is planned that will test the effectiveness of the robot in chronic and subacute stroke subjects. Thirty stroke subjects will receive approximately 80 minutes of therapy each weekday until 24 treatment sessions are received. Subjects will be randomized to receive robotic therapy or a control therapy. The control therapy will be matched to the robotic therapy in terms of type and amount of activities, but all activities will be performed without assistance from a robot. Outcomes will be measures of movement kinematics and functional ability. These data would provide critical evidence for the added value of robotic assistance during arm movement therapy after stroke. |
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| PERSONNEL |
P. Lum and T. Nef |
| FUNDING SOURCE |
NRH |
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