ARM STUDIO TO INTENSIFY UPPER LIMB REHABILITATION AFTER STROKE: CONCEPT, ACCEPTANCE, UTILIZATION AND PRELIMINARY CLINICAL RESULTS

Objectives: To assess the acceptance, utilization and clinical results of an arm studio designed to intensify treatment of the severely to moderately affected arm after stroke. In line with a distal bilateral approach, the equipment comprised 4 workstations, 1 finger trainer, and 3 machines for bilateral training of selected distal and proximal movements. Design: Open study. Subjects: Of 119 treated patients after subacute stroke, 30 completed a questionnaire and 24 were assessed. Methods: All patients completed 15 sessions, each of 30-45 min duration, on each of 2 workstations. Based on the patients' impairment level they were divided into 3 groups, as follows: group A, plegic; group B, proximal and distal movements but hand non-functional; and group C, able to grasp and release an object. Motor functions were assessed with the Fugl-Meyer Score (FM, 0-66) for groups A (n=6) and B (n=6), and the Action Arm Research Test (ARAT, 0-57) for group C (n=12). Results: No side-effects occurred. The patients regarded the training positively. The initial FM was 8.5 (standard deviation (SD) 3.3) and final FM 21.2 (SD 4.4) for group A, initial FM 25.3 (SD 6.9) and final FM 44.3 (SD 9.1) for group B, and initial ARAT 33.3 (SD 11.2) and final ARAT 43.5 (SD 10.7) for group C. Conclusion: The use of the arm studio to intensify upper limb rehabilitation after stroke is promising, and a controlled study is warranted.