Date Presented 04/04/2025
A clinical trial in an inpatient rehabilitation facility was conducted to explore the impact of use of the bimanual arm trainer on upper extremity function among persons with stroke. This study adds to the discussion about use of robotics in OT.
Primary Author and Speaker: Kacy Welch
Additional Authors and Speakers: Patty Danz, Tristen Kvedar
Contributing Authors: Patty Danz, Teresina Bradbury, Tristen Kvedar
PURPOSE: Upper extremity dysfunction resulting from stroke significantly impacts an individual’s ability to complete self-care activities, consequently diminishing functional independence. There is a need for effective interventions that improve upper extremity function in persons with stroke. This study sought to explore whether the Bimanual Arm Trainer would result in greater improvements in upper extremity function after acute ischemic stroke than traditional occupational therapy treatment sessions (i.e., control group).
DESIGN: Clinical trial, two-group, non-randomized repeated-measures design. The control group was comprised of retrospective chart reviews of adults (18+) with ischemic stroke to obtain demographic data and ARAT scores. The experimental group was comprised of adults (18+) with ischemic stroke who scored less than 17 on initial ARAT score and deemed cognitively able to utilize the bimanual arm trainer.
METHOD: Retrospective chart review was utilized to obtain demographic data and ARAT scores for the control group. The Action Research Arm Test and the Fugl-Meyer Assessment for upper extremity were utilized to assess arm function.
RESULTS: Both the intervention and control groups showed significant improvement on the Action Research Arm Test from evaluation to discharge; however, there was no significant difference between the two groups. Fugl-Meyer Assessment scores improved significantly in the intervention group from evaluation to discharge (p <0.001); however, Fugl-Meyer scores were not available for the control group for comparison.
CONCLUSION: Participants that utilized the Bimanual Arm Trainer demonstrated similar improvements in upper extremity function as those who only engaged in traditional occupational therapy. These results give us insight into the usefulness and appropriate practice areas of this piece of innovative technology. Further exploration can address how it can be utilized for maximizing outcomes for patients.
References
Chen, P., Kwong, P. W. H., Lai, C. K. Y., & Ng, S. S. M. (2019). Comparison of bilateral and unilateral upper limb training in people with stroke: A systematic review and meta-analysis. Plos One, 14(5) https://doi.org/10.1371/journal.pone.0216357
Raghavan, P., Aluru, V., Milani, S., Thai, P., Geller, D., Bilaloglu, S., . . . Weisz, D. J. (2017). Coupled bimanual training using a non-powered device for individuals with severe hemiparesis: A pilot study. International Journal of Physical Medicine & Rehabilitation, 05(03) https://doi.org/10.4172/2329-9096.1000404
Warland, A., Paraskevopoulos, I., Tsekleves, E., Ryan, J., Nowicky, A., Griscti, J., . . . Kilbride, C. (2018). The feasibility, acceptability and preliminary efficacy of a low-cost, virtual-reality based, upper-limb stroke rehabilitation device: A mixed methods study. Disability and Rehabilitation, 41(18) https://doi.org/10.1080/09638288.2018.1459881
Sethy, D., Sahoo, S., Kujur, E., & Bajpai, P. (2018). Stroke upper extremity rehabilitation: Effect of bilateral arm training. International Journal of Health & Allied Sciences, 7(4), 217–221. Retrieved from http://www.ijhas.in/article.asp?issn=2278-344X;year=2018;volume=7;issue=4;spage=217;epage=221;aulast=Sethy;type=0
