1. Rehabilitation Institute of Chicago Sensory Motor Performance Program (SMPP) Guided Force Training with the ARM Guide in Chronic Stroke Lennie Kahn, PhD W. Zev Rymer, MD, PhD David Reinkensmeyer, PhD Jason Barbas, MPT Heidi Fischer, MS, OTR/L Heidi Roth, MSPT Kahn Project Summary for Mars RERC Advisory Board Meeting, Nov 10, 2005 ` `MARSRERC

2. Rehabilitation Institute of Chicago ` `MARSRERC Background MIME (Mirror Image Movement Enabler) ARM Guide (Assisted Rehabilitation and Measurement)

3. Rehabilitation Institute of Chicago ` `MARSRERC Free reaching results

4. Rehabilitation Institute of Chicago ` `MARSRERC Aims and Hypotheses Aims: Aims: –to implement guided force training with the ARM Guide –to compare guided force training with traditional therapy and free reaching therapy for restoring UE function Hypotheses: Guided force training… Hypotheses: Guided force training… –accounts for the differences between the MIME and ARM Guide free reaching outcomes –will be more effective than free reaching exercises and traditional therapy in promoting arm movement recovery

5. Rehabilitation Institute of Chicago ` `MARSRERC The ARM Guide and Guided Force Training

6. Rehabilitation Institute of Chicago ` `MARSRERC Alternative training approaches Conventional OT Conventional OT –Scapular/shoulder alignment –Passive & active ROM –Task-oriented re-education Free reaching Free reaching 1 2 3 4 5 All subjects practice 1 hr per day, 3 days a week, for 8 weeks = 24 sessions

7. Rehabilitation Institute of Chicago ` `MARSRERC Since the last meeting Added a fourth therapy group combining all three therapy approaches Added a fourth therapy group combining all three therapy approaches Trained 20 participants (making total of 24) Trained 20 participants (making total of 24) –8 guided force training –5 free reaching therapy –5 traditional OT –2 in mixed approach

8. Rehabilitation Institute of Chicago ` `MARSRERC Early outcomes Based on 24 subjects completing program Based on 24 subjects completing program –7 traditional OT, 8 guided force, 9 free reaching

9. Rehabilitation Institute of Chicago ` `MARSRERC Free reaching pre-postp < 0.001 pre-post x group p = 0.196 target p < 0.01 pre-postp > 0.6 pre-post x group p > 0.4

10. Rehabilitation Institute of Chicago ` `MARSRERC Functional outcomes Fugl-MeyerRancho Los Amigos Wolf Motor Function Test

11. Rehabilitation Institute of Chicago ` `MARSRERC Plans for the coming year Complete the planned 14 subjects per group – statistician consult Complete the planned 14 subjects per group – statistician consult Train 6 subjects in the mixed approach Train 6 subjects in the mixed approach Present preliminary results at AOTA Present preliminary results at AOTA Present preliminary results at BioRob 2006 Present preliminary results at BioRob 2006