AUTHOR=Pila Ophélie , Koeppel Typhaine , Grosmaire Anne-Gaëlle , Duret Christophe 

TITLE=Impact of Dose of Combined Conventional and Robotic Therapy on Upper Limb Motor Impairments and Costs in Subacute Stroke Patients: A Retrospective Study

JOURNAL=Frontiers in Neurology

VOLUME=Volume 13 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2022.770259

DOI=10.3389/fneur.2022.770259

ISSN=1664-2295

ABSTRACT=Introduction: Robot-based training integrated into usual care might optimize therapy productivity and increase treatment dose. This retrospective study compared two doses of an upper limb rehabilitation program combining robot-assisted therapy and occupational therapy on motor recovery and costs after stroke.
Methods: Thirty-six subacute stroke patients (Fugl-Meyer Assessement (FMA) score 32±12 points; mean±SD) underwent a combined program of 29±3 sessions of robot-assisted therapy and occupational therapy. Scheduled session time for the higher dose group was 90 minutes (two 45-min sessions; n=14) and for the lower dose group was 60 minutes (two 30-min sessions; n=22). Pre-/post-treatment change in FMA score (∆FMA, %), actual active time (min), number of movements and number of repetitions per minute per robot-assisted therapy session were compared between groups. The costs of the combined programs were also analyzed.
Results: ∆FMA did not differ significantly between groups; the higher dose group improved by +16±13 % and the lower dose group by +11±8 %. A between-group difference was found for actual active time (p=1.06E-13) and number of movements (p=4.42E-2) but not for number of repetitions per minute during robot-assisted therapy: the higher dose group performed 1023±344 movements over 36±3 minutes and the lower dose group performed 796±301 movements over 29±1 minutes. Both groups performed 28 repetitions per minute. The combined program cost was €2017 and €1162 for the higher and lower dose groups, respectively.
Conclusions: Similar motor improvements were observed following two doses of movement-based training. The reduction in scheduled session time did not affect the intensity of the practice and met economic constraints.