Robot-assisted therapy in chronic stroke patients: a daily diary n-of-1 trial

Abstract

Background: Stroke patients often face reduced mobility and loss of upper extremity function, potentially limiting independence in daily activities. In post-stroke rehabilitation patients should relearn important movements and skills. Robot-assisted therapy is a novel approach that has been shown to help patients significantly improve functioning in their paretic arm. However, it remains unclear whether these improvements, observed in clinical assessments in pre-post designs, also translate into daily activities. The aim of the study is to investigate how chronic stroke patients experience daily life and whether receiving robot-assisted therapy in a social environment results in heightened motor activity in the paretic arm. Methods: In six experimental n-of-1 trials with chronic stroke patients, data on objectively measured at home activity, socio-cognitive variables related to at home activity, and indicators of wellbeing will be assessed across several weeks. After establishing a baseline, three different experimental conditions (no rehabilitation, solo robot-therapy, dyadic robot-therapy with partner) will be implemented and compared within patients. Expected results: This study is a pilot feasibility study for testing the different experimental conditions and to inform a larger project. Current stage of work: Currently, the solo and dyadic modes of training with ARMin (the rehabilitation robot) are being programed. Recruitment and data collection will commence in May 2017. Discussion: Fostering daily at-home exercises of a paretic arm is an important goal in stroke rehabilitation. By examining the effects of different robot-assisted therapies on exercising behaviour, this study will contribute to the optimization of the stroke rehabilitation process.