Dose and staffing comparison study of upper limb device-assisted therapy

Document Type

Journal Article

Publication Title

NeuroRehabilitation: an interdisciplinary journal


IOS Press


School of Medical and Health Sciences




Wuennemann, M. J., Mackenzie, S. W., Lane, H. P., Peltz, A. R., Ma, X., Gerber, L. M., ... & Kitago, T. (2020). Dose and staffing comparison study of upper limb device-assisted therapy. NeuroRehabilitation. 46(3), 287-297. https://doi.org/10.3233/NRE-192993


BACKGROUND:Neurological injuries cause persistent upper extremity motor deficits. Device-assisted therapy is an emerging trend in neuro-rehabilitation as it offers high intensity, repetitive practice in a standardized setting. OBJECTIVE:To investigate the effects of therapy duration and staff-participant configuration on device-assisted upper limb therapy outcomes in individuals with chronic paresis. METHODS:Forty-seven participants with chronic upper extremity weakness due to neurological injury were assigned to a therapy duration (30 or 60 min) and a staff-participant configuration (1-to-1 or 1-to-2). Therapy consisted of 3 sessions a week for 6 weeks using the Armeo®Spring device. Clinical assessments were performed at three timepoints (Pre, Post, and 3 month Follow up). RESULTS:Improvements in upper limb impairment, measured by change in Fugl-Meyer score (FM), were observed following therapy in all groups. FM improvement was comparable between 30 and 60 min sessions, but participants in the 1-to-2 group had significantly greater improvement in FM from Pre-to-Post and from Pre-to-Follow up than the 1-to-1 group. CONCLUSIONS:Device-assisted therapy can reduce upper limb impairment to a similar degree whether participants received 30 or 60 min per session. Our results suggest that delivering therapy in a 1-to-2 configuration is a feasible and more effective approach than traditional 1-to-1 staffing.



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