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The Armeo Spring as training tool to improve upper limb functionality in multiple sclerosis: a pilot study.

Gijbels D, Lamers I, Kerkhofs L, Alders G, Knippenberg E, Feys P - J Neuroeng Rehabil (2011)

Bottom Line: Muscle strength did not change significantly.Significant gains were particularly found in functional capacity tests.After training completion, TEMPA scores improved (p = 0.02), while a trend towards significance was found for the 9HPT (p = 0.05).

View Article: PubMed Central - HTML - PubMed

Affiliation: REVAL Rehabilitation Research Center, Hasselt University, Agoralaan Building A, BE-3590 Diepenbeek, Belgium. domien.gijbels@uhasselt.be

ABSTRACT

Background: Few research in multiple sclerosis (MS) has focused on physical rehabilitation of upper limb dysfunction, though the latter strongly influences independent performance of activities of daily living. Upper limb rehabilitation technology could hold promise for complementing traditional MS therapy. Consequently, this pilot study aimed to examine the feasibility of an 8-week mechanical-assisted training program for improving upper limb muscle strength and functional capacity in MS patients with evident paresis.

Methods: A case series was applied, with provision of a training program (3×/week, 30 minutes/session), supplementary on the customary maintaining care, by employing a gravity-supporting exoskeleton apparatus (Armeo Spring). Ten high-level disability MS patients (Expanded Disability Status Scale 7.0-8.5) actively performed task-oriented movements in a virtual real-life-like learning environment with the affected upper limb. Tests were administered before and after training, and at 2-month follow-up. Muscle strength was determined through the Motricity Index and Jamar hand-held dynamometer. Functional capacity was assessed using the TEMPA, Action Research Arm Test (ARAT) and 9-Hole Peg Test (9HPT).

Results: Muscle strength did not change significantly. Significant gains were particularly found in functional capacity tests. After training completion, TEMPA scores improved (p = 0.02), while a trend towards significance was found for the 9HPT (p = 0.05). At follow-up, the TEMPA as well as ARAT showed greater improvement relative to baseline than after the 8-week intervention period (p = 0.01, p = 0.02 respectively).

Conclusions: The results of present pilot study suggest that upper limb functionality of high-level disability MS patients can be positively influenced by means of a technology-enhanced physical rehabilitation program.

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Related in: MedlinePlus

Case profiles of time performance on the TEMPA. Outcomes were measured at baseline (PRE), after 8 weeks of Armeo Spring training (POST), and at 2-month follow-up (FU).P, patient.
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Figure 3: Case profiles of time performance on the TEMPA. Outcomes were measured at baseline (PRE), after 8 weeks of Armeo Spring training (POST), and at 2-month follow-up (FU).P, patient.

Mentions: Significant improvements were particularly found in functional capacity parameters (see Figure 2). At completion of the training program, the functional activities of the TEMPA were performed significantly faster compared to baseline, while time scores on the 9HPT gave evidence of a positive trend. ARAT scores increased 4 points on average, not being significant however. Largest gains were observed in subjects most affected at baseline, more specifically in 4 individuals who initially required a TEMPA execution time of more than 60 seconds (see Figure 3 in illustration of this finding) and a 9HPT execution time of more than 180 seconds, besides scoring less than 41 points on the ARAT. In fact, these 4 subjects were not able to accomplish one or more TEMPA tasks (all 4 individuals) or the 9HPT (2 out of 4 individuals) within the specified maximal time frame before the intervention, while most of them were capable after the intervention (3 out of 4, and 4 out 4 individuals respectively). At 2-month follow-up, results on the TEMPA and ARAT revealed even greater and for both measures significant gains relative to baseline than immediately after the intervention period, despite the fact that in the meantime no supplementary mechanical-assisted training had taken place. The 9HPT outcomes approximated the post-training performance levels.


The Armeo Spring as training tool to improve upper limb functionality in multiple sclerosis: a pilot study.

Gijbels D, Lamers I, Kerkhofs L, Alders G, Knippenberg E, Feys P - J Neuroeng Rehabil (2011)

Case profiles of time performance on the TEMPA. Outcomes were measured at baseline (PRE), after 8 weeks of Armeo Spring training (POST), and at 2-month follow-up (FU).P, patient.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3037310&req=5

Figure 3: Case profiles of time performance on the TEMPA. Outcomes were measured at baseline (PRE), after 8 weeks of Armeo Spring training (POST), and at 2-month follow-up (FU).P, patient.
Mentions: Significant improvements were particularly found in functional capacity parameters (see Figure 2). At completion of the training program, the functional activities of the TEMPA were performed significantly faster compared to baseline, while time scores on the 9HPT gave evidence of a positive trend. ARAT scores increased 4 points on average, not being significant however. Largest gains were observed in subjects most affected at baseline, more specifically in 4 individuals who initially required a TEMPA execution time of more than 60 seconds (see Figure 3 in illustration of this finding) and a 9HPT execution time of more than 180 seconds, besides scoring less than 41 points on the ARAT. In fact, these 4 subjects were not able to accomplish one or more TEMPA tasks (all 4 individuals) or the 9HPT (2 out of 4 individuals) within the specified maximal time frame before the intervention, while most of them were capable after the intervention (3 out of 4, and 4 out 4 individuals respectively). At 2-month follow-up, results on the TEMPA and ARAT revealed even greater and for both measures significant gains relative to baseline than immediately after the intervention period, despite the fact that in the meantime no supplementary mechanical-assisted training had taken place. The 9HPT outcomes approximated the post-training performance levels.

Bottom Line: Muscle strength did not change significantly.Significant gains were particularly found in functional capacity tests.After training completion, TEMPA scores improved (p = 0.02), while a trend towards significance was found for the 9HPT (p = 0.05).

View Article: PubMed Central - HTML - PubMed

Affiliation: REVAL Rehabilitation Research Center, Hasselt University, Agoralaan Building A, BE-3590 Diepenbeek, Belgium. domien.gijbels@uhasselt.be

ABSTRACT

Background: Few research in multiple sclerosis (MS) has focused on physical rehabilitation of upper limb dysfunction, though the latter strongly influences independent performance of activities of daily living. Upper limb rehabilitation technology could hold promise for complementing traditional MS therapy. Consequently, this pilot study aimed to examine the feasibility of an 8-week mechanical-assisted training program for improving upper limb muscle strength and functional capacity in MS patients with evident paresis.

Methods: A case series was applied, with provision of a training program (3×/week, 30 minutes/session), supplementary on the customary maintaining care, by employing a gravity-supporting exoskeleton apparatus (Armeo Spring). Ten high-level disability MS patients (Expanded Disability Status Scale 7.0-8.5) actively performed task-oriented movements in a virtual real-life-like learning environment with the affected upper limb. Tests were administered before and after training, and at 2-month follow-up. Muscle strength was determined through the Motricity Index and Jamar hand-held dynamometer. Functional capacity was assessed using the TEMPA, Action Research Arm Test (ARAT) and 9-Hole Peg Test (9HPT).

Results: Muscle strength did not change significantly. Significant gains were particularly found in functional capacity tests. After training completion, TEMPA scores improved (p = 0.02), while a trend towards significance was found for the 9HPT (p = 0.05). At follow-up, the TEMPA as well as ARAT showed greater improvement relative to baseline than after the 8-week intervention period (p = 0.01, p = 0.02 respectively).

Conclusions: The results of present pilot study suggest that upper limb functionality of high-level disability MS patients can be positively influenced by means of a technology-enhanced physical rehabilitation program.

Show MeSH
Related in: MedlinePlus