Disclosures: Alberto Esquenazi, MD: Allergan (Products/Services: Yes) (Consultant/Advisory Board, Research Grant or Support, Research Grant includes principal investigator, collaborator or consultant and pending grants as well as grants already received)

Objective: To describe the use of an additional hour of robotic or conventional upper (UL) or lower limb (LL) therapy in inpatient stroke rehabilitation.

Design: Randomized, single-blinded, pilot studies. Setting : Acute, stroke inpatient rehabilitation unit. Participants : 75 acute post-stroke adults with unilateral hemiparesis UL study (ULS) – 30, LL study (LLS) – 45 with a Modified Ashworth Scale (MAS) score ≤3 and UL Fugl Meyer Assessment (FMA) score > 8.

Interventions: ULS – Participants were randomized to Tabletop assisted therapy (TAT) UL or conventional gait therapy LL vs. ARMEO or Lokomat in an inpatient rehabilitation facility (IRF).

Main Outcome Measures: ULS – completed number of treatments; withdrawals; serious/adverse events (S/AEs); Functional Independence Measure (FIM) Motor; FIM efficiency; Modified Ashworth Scale (MAS); Active/Passive Range of Motion (A/PROM) and therapist effort measured by the Modified Borg Rating of Perceived Exertion Scale (RPE); LLS – also had FIM motor efficiency; Functional Ambulation Category (FAC); 5-Times Sit-To-Stand (5x-STS); 10-meter walk test (10MWT); 2-minute walk test (2MWT) and Trunk control test (TCT).

Results: ULS – Post-intervention FIM and FMA scores increased in both groups (p = .585, .962, partial n2 = .001, .001, respectively). There were no statistically significant differences in post-intervention MAS elbow flexion and extension and A/PROM elbow extension between training groups. Post-intervention A/PROM elbow flexion was statistically significantly different between groups (p = .031, .018, partial n2 = .123, .146). Post-intervention RPE did not show any statistically significant differences between the training groups (p = .128, partial n2 = .063). No SAEs were reported. LLS – Post-intervention FIM, ankle MAS, knee MAS, 5x-STS, 2MWT, 10MWT, TCT, FAC, PROM (ankle, knee and hip) were not statistically different between training groups. No SAEs were reported. Conclusions: The studies support increase in early intensive UL and LL retraining to promote recovery in acute stroke rehabilitation as feasible and tolerated in acute post-stroke patients.

Level of Evidence: Level I

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/the-implementation-of-additional-therapy-time-in-acute-post-stroke-rehabilitation/