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Article

The Effects of Distributed vs. Condensed Schedule for Robot-Assisted Training with Botulinum Toxin A Injection for Spastic Upper Limbs in Chronic Post-Stroke Subjects

1
Department of Rehabilitation, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung 83301, Taiwan
2
School of Medicine, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
3
Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Taoyuan 33302, Taiwan
4
Healthy Aging Research Center, Chang Gung University, Taoyuan 33302, Taiwan
5
Division of Cerebrovascular Diseases, Department of Neurology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung 83301, Taiwan
6
Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Linkou, Taoyuan 33305, Taiwan
*
Author to whom correspondence should be addressed.
Toxins 2021, 13(8), 539; https://doi.org/10.3390/toxins13080539
Received: 26 May 2021 / Revised: 14 July 2021 / Accepted: 29 July 2021 / Published: 1 August 2021
(This article belongs to the Section Bacterial Toxins)
Robot-assisted training (RT) combined with a Botulinum toxin A (BoNT-A) injection has been suggested as a means to optimize spasticity treatment outcomes. The optimal schedule of applying RT after a BoNT-A injection has not been defined. This single-blind, randomized controlled trial compared the effects of two predefined RT approaches as an adjunct to BoNT-A injections of spastic upper limbs in chronic post-stroke subjects. Thirty-six patients received a BoNT-A injection in the affected upper extremity and were randomly assigned to the condensed or distributed RT group. The condensed group received an intervention of four sessions/week for six consecutive weeks. The distributed group attended two sessions/week for 12 consecutive weeks. Each session included 45 min of RT using the InMotion 2.0 robot, followed by 30 min of functional training. The Fugl-Meyer Assessment, Modified Ashworth Scale, Wolf Motor Function Test, Motor Activity Log, and Stroke Self-Efficacy Questionnaire were assessed at pre-training, mid-term, post-training, and at 6 week follow-up, with the exception of the Motor Activity Log, which did not include mid-term measures. After the intervention, both groups had significant improvements in all outcome measures (within-group effects, p < 0.05), with the exception of the Wolf Motor Function Test time score. There were no significant differences between groups and interaction effects in all outcome measures. Our findings suggest that RT provided in a fixed dosage as an adjunct to a BoNT-A injection has a positive effect on participants’ impairment and activity levels, regardless of treatment frequency. (ClinicalTrials.gov: NCT03321097). View Full-Text
Keywords: robotics; spasticity; stroke; rehabilitation; upper extremity robotics; spasticity; stroke; rehabilitation; upper extremity
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MDPI and ACS Style

Hung, J.-W.; Chen, Y.-W.; Chen, Y.-J.; Pong, Y.-P.; Wu, W.-C.; Chang, K.-C.; Wu, C.-Y. The Effects of Distributed vs. Condensed Schedule for Robot-Assisted Training with Botulinum Toxin A Injection for Spastic Upper Limbs in Chronic Post-Stroke Subjects. Toxins 2021, 13, 539. https://doi.org/10.3390/toxins13080539

AMA Style

Hung J-W, Chen Y-W, Chen Y-J, Pong Y-P, Wu W-C, Chang K-C, Wu C-Y. The Effects of Distributed vs. Condensed Schedule for Robot-Assisted Training with Botulinum Toxin A Injection for Spastic Upper Limbs in Chronic Post-Stroke Subjects. Toxins. 2021; 13(8):539. https://doi.org/10.3390/toxins13080539

Chicago/Turabian Style

Hung, Jen-Wen, Yen-Wei Chen, Yi-Ju Chen, Ya-Ping Pong, Wen-Chi Wu, Ku-Chou Chang, and Ching-Yi Wu. 2021. "The Effects of Distributed vs. Condensed Schedule for Robot-Assisted Training with Botulinum Toxin A Injection for Spastic Upper Limbs in Chronic Post-Stroke Subjects" Toxins 13, no. 8: 539. https://doi.org/10.3390/toxins13080539

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