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| Name | Class |
|---|---|
| Gaylord Hospital | UNKNOWN |
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The Barrett Upper Extremity Robot (BURT) is an FDA-approved upper extremity robot that assists patients with both passive and active range of motion while providing adjustable resistance (Barrett_Medical. Robotic Assist Rehabilitation Made Easy. https://medical.barrett.com/). Activities are directed by therapists and encourage patient involvement through video game activities providing active proprioceptive, vibrational, visual and auditory feedback. Engaging and colorful games are beneficial in holding patients' interest, and gravity assistance may also allow for increased repetition in the face of patient fatigue.
In this prospective study, the investigators will determine if a standardized BURT Upper Extremity (UE) program can be consistently implemented within an acute inpatient rehabilitation facility (IRF). In addition, the investigators will see if patients who receive BURT have improved UE mobility and function as a result. The investigators will also study the perceived enjoyment and value of the intervention by patients, and perceived value by therapists.
Because BURT therapy is able to provide more repetitions of upper extremity movement in a shorter length of time than conventional therapy, the investigators hypothesize that patients who participate in neuro re-education activities using BURT will achieve greater improvements in strength, upper extremity function, fine motor coordination, activities of daily living and mobility during their time in an IRF than patients receiving conventional therapy.
In this study, eligible patients admitted to Sunnyview Rehabilitation Hospital (SRH) for rehabilitation following stroke will be randomized to receive conventional or BURT therapy. Meaningful clinical benchmarks for upper extremity function, tone, fine motor coordination, activities of daily living and mobility will be assessed using the Upper Extremity Motor Assessment Scale (UE-MAS)(Zelter, 2010), manual muscle testing (MMT), Modified Ashworth Scale (MAS) (Figueiredo, 2011) and the 9-hole peg test (9HPT)(Figueiredo, 2011). The investigators also hypothesize that patients in the BURT cohort will report greater value/usefulness and interest/enjoyment.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Conventional Upper Extremity Neuroeducation | Active Comparator | 74 patients will receive the standard occupational therapy sessions that they would normally receive during their IRF stay. UE neuroeducation sessions are typically focused on improving strength and mobility of the upper arm. Clinicians will not be given instructions on how to run their sessions, however they will not be allowed to use BURT. Other devices that would normally be used during neuro-educational sessions (including X-cite, electrical stimulation and RT-300) will be allowed for use in this group. The therapists will track the activity, level of assistance and time provided in a tracking sheet, as well as document any adverse events that may occur |
|
| BURT Upper Extremity | Experimental | As part of routine therapy, 74 patients will receive up to 5 sessions per week of BURT UE therapy in place of conventional neuro re-education. Patients in this arm of the study will receive any conventional therapy during the remainder of their treatment sessions. When using BURT, therapists will track the activity, level of assistance and time provided in a tracking sheet, as well as document any adverse events that may occur. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| BURT | Device | Use of Barrett Upper extremity Robot (BURT) to improve strength and mobility of hemiplegic upper extremity. |
|
| Measure | Description | Time Frame |
|---|---|---|
| UE Motor Assessment Scale (UE-MAS) | Used to assess motor functions in the affected upper extremity following a stroke. This evaluation uses task-oriented techniques instead of isolated movement patterns. | T2(Day 20-23) - T0 (Day 4-6) |
| UE Motor Assessment Scale (UE-MAS) | Used to assess motor functions in the affected upper extremity following a stroke. This evaluation uses task-oriented techniques instead of isolated movement patterns. | T1 (Day 12-14) - T0 (Day 4-6) |
| Manual Muscle Testing (MMT) | Used to assess the strength in a persons upper extremity based on various planes of movement. This is the most commonly used strength assessment. | T2(Day 20-23) - T0 (Day 4-6) |
| Manual Muscle Testing (MMT) | Used to assess the strength in a persons upper extremity based on various planes of movement. This is the most commonly used strength assessment. | T1 (Day 12-14) - T0 (Day 4-6) |
| Modified Ashworth Scale (MAS) | The modified Ashworth Scale is the primary measure for muscle spasticity in the upper extremities for patients with neurological conditions. | T2(Day 20-23) - T0 (Day 4-6) |
| Modified Ashworth Scale (MAS) | The modified Ashworth Scale is the primary measure for muscle spasticity in the upper extremities for patients with neurological conditions. | T1 (Day 12-14) - T0 (Day 4-6) |
| 9 Hole Peg Test (9HPT) |
| Measure | Description | Time Frame |
|---|---|---|
| GG Scores for Self-Care Items | standardized assessments of functional independence for feeding, bathing, toileting, footwear, upper and lower body dressing and oral hygiene. | Change from admission to discharge, up to 55 days |
| GG Scores for Mobility items |
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Inclusion Criteria:
Exclusion Criteria:
>30 days post stroke
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| Name | Affiliation | Role |
|---|---|---|
| Casey Cowan, MS OTR/L | Sunnyview Rehabilitation Hospital | Principal Investigator |
| Emily Steenburgh, MS OTR/L | Sunnyview Rehabilitation Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Gaylord Hospital | Wallingford | Connecticut | 06492 | United States | ||
| Sunnyview Rehabilitation Hospital |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| Background | Barrett_Medical. Robotic Assist Rehabilitation Made Easy. https://medical.barrett.com/ | ||
| Background | Zelter L. 2010. Motor Assessment Scale (MAS). https://strokengine.ca/en/assessments/motor-assessment-scale-mas/#:~:text=The%20Motor%20Assessment%20Scale%20(MAS,leakage%20from%20a%20blood%20vessel. | ||
| Background | Figueiredo S ZL. 2011. Modified Ashworth Scale. https://strokengine.ca/en/assessments/modified-ashworth-scale/ | ||
| Background | Figueiredo S. 2011. Nine Hole Peg Test (NHPT). https://strokengine.ca/en/assessments/nine-hole-peg-test-nhpt/ |
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| Other Occupational Therapy | Procedure | Standard occupational therapy sessions will be 60-90 minutes a day and are UE neuroeducation sessions are typically focused on improving strength and mobility of the hemipelagic arm. |
|
The 9HPT is a standardized test that measures manual dexterity. |
| T2(Day 20-23) - T0 (Day 4-6) |
| 9 Hole Peg Test (9HPT) | The 9HPT is a standardized test that measures manual dexterity. | T1 (Day 12-14) - T0 (Day 4-6) |
standardized assessments of functional independence for bed mobility and transfers. |
| Change from admission to discharge, up to 55 days |
| Schenectady |
| New York |
| 12308 |
| United States |
| ID | Term |
|---|---|
| D020521 | Stroke |
| ID | Term |
|---|---|
| D002561 | Cerebrovascular Disorders |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
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