Effects of combined robotic therapy and repetitive-task practice on upper-extremity function in a patient with chronic stroke.

OBJECTIVE This article describes the effect of a robotic device combined with repetitive-task practice (RTP) on upper-extremity function in a patient with chronic stroke. METHOD The client was a 32-year-old woman, 11 months after stroke, with minimal wrist and finger movement. She received approximately 48 hr of intervention split evenly between a robotic device (Hand Mentor) and RTP during 3 weeks. RESULTS Favorable scores in the Wolf Motor Function Test were observed from pre- to postevaluation. Active range of motion, from pre- to postintervention, increased by 35 degrees in the shoulder, 65 degrees in the wrist, and 70 degrees in the thumb. Kinetic analysis of a bimanual dexterity task indicated improved specification of grasping forces for both limbs. CONCLUSION Improvements in upper-extremity motor functioning and functional performance in daily tasks followed this client's engagement in distal initiation of movement during an RTP exercise regimen that was robotically reinforced.