ABSTRACT
DESIGN: Within-subjects repeated-measures design evaluating reaching with and without the Therapy Assistant Wilmington Robotic Exoskeleton (WREX). SETTING: Laboratory. PARTICIPANTS: Stroke survivors (N=10) with chronic upper-extremity hemiparesis. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Arm movement kinematics (Optotrak Certus motion detection system), muscle activity for biceps, triceps, anterior deltoid, and brachioradialis muscles (bipolar surface electromyography). RESULTS: Significant improvements of reaching distance occurred for all subjects across all targets (P<.001) when using the Therapy Assistant WREX. While the self-selected peak speed of hand movement during the reach decreased significantly with the Therapy Assistant WREX (P<.001), use of the Therapy Assistant WREX led to improved quality of movement as signified by a decrease in jerk (P<.001) and a shift in the timing of the peak speed to an earlier point in the movement (P<.001). Electromyographic muscle activity analysis showed that use of the Therapy Assistant WREX led to a reduction in biceps activity across all targets during the reach (P<.05), in conjunction with a marginally significant reduction in activity of the anterior deltoid (P<.055). No changes were observed in triceps (P=.47) or brachioradialis activity (P=.28). CONCLUSIONS: By reducing requirements for shoulder activation, the Therapy Assistant WREX improved reaching performance among stroke survivors compared with free reaching, thereby potentially facilitating practice of functional tasks.
