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Upper Limb Robotic Therapy for Children with Hemiplegia

Fasoli, Susan E. ScD, OTR/L; Fragala-Pinkham, Maria PT, MS; Hughes, Richard PT, MS, NCS; Hogan, Neville PhD; Krebs, Hermano Igo PhD; Stein, Joel MD

American Journal of Physical Medicine & Rehabilitation: November 2008 - Volume 87 - Issue 11 - p 929-936
doi: 10.1097/PHM.0b013e31818a6aa4
Original Research Article: Hemiplegia

Fasoli SE, Fragala-Pinkham M, Hughes R, Hogan N, Krebs HI, Stein J: Upper limb robotic therapy for children with hemiplegia. Am J Phys Med Rehabil 2008;87:929–936.

Objective: Our aim was to examine the feasibility and effects of robotic therapy for children with cerebral palsy and upper limb hemiplegia.

Design: A single group within-subjects design was used. Twelve children aged 5–12 yrs with moderate to severe motor impairments participated in 1-hr robotic therapy sessions, 2 times per week for 8 wks. During each session, children used the paretic arm to perform 640 repetitive, goal-directed planar reaching movements, with robotic assistance as needed. Primary outcomes were the Quality of Upper Extremity Skills Test (QUEST) and the Fugl-Meyer Assessment upper limb subtest. Secondary outcomes were the Modified Ashworth Scale, peak isometric strength of shoulder and elbow muscles, and parent questionnaire scores.

Results: We found significant gains in total QUEST and Fugl-Meyer Assessment scores at discharge and follow-up and in isometric strength of elbow extensors at discharge. The parent questionnaire showed significant improvements in “how much” and “how well” children used the paretic arm during daily functional tasks at home.

Conclusion: Robotic therapy can provide new opportunities for improving upper limb coordination and function in children with moderate to severe impairments due to cerebral palsy or stroke.

From the Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, Massachusetts (SEF, RH, JS); Franciscan Hospital for Children, Brighton, Massachusetts (MF-P); and Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts (NH, HIK).

All correspondence and requests for reprints should be addressed to Susan E. Fasoli, ScD, OTR/L, Newton Wellesley Hospital, 2014 Washington Street, Newton, MA 02462.

This project was supported by a grant from the Charles H. Hood Foundation, Boston, MA (to SEF). Drs. H. I. Krebs and N. Hogan are coinventors in the MIT-held patent for the robotic device used to treat patients in this work. They hold equity positions in Interactive Motion Technologies, Inc., the company that manufactures this type of technology under license to MIT.

© 2008 Lippincott Williams & Wilkins, Inc.