Authors:
Susan E. Fasoli, ScD, OTR/L
Maria Fragala-Pinkham, PT, MS
Richard Hughes, PT, MS, NCS
Neville Hogan, PhD
Hermano Igo Krebs, PhD
Joel Stein, MD
Affiliations:
From the Department of Physical
Medicine and Rehabilitation,
Spaulding Rehabilitation Hospital,
Harvard Medical School, Boston,
Massachusetts (SEF, RH, JS);
Franciscan Hospital for Children,
Brighton, Massachusetts (MF-P);
and Department of Mechanical
Engineering, Massachusetts Institute
of Technology, Cambridge,
Massachusetts (NH, HIK).
Correspondence:
All correspondence and requests for
reprints should be addressed to Susan
E. Fasoli, ScD, OTR/L, Newton
Wellesley Hospital, 2014 Washington
Street, Newton, MA 02462.
Disclosures:
This project was supported by a grant
from the Charles H. Hood
Foundation, Boston, MA (to SEF).
Drs. H. I. Krebs and N. Hogan are
coinventors in the MIT-held patent
for the robotic device used to treat
patients in this work. They hold
equity positions in Interactive Motion
Technologies, Inc., the company that
manufactures this type of technology
under license to MIT.
0894-9115/08/8711-0929/0
American Journal of Physical
Medicine & Rehabilitation
Copyright © 2008 by Lippincott
Williams & Wilkins
DOI: 10.1097/PHM.0b013e31818a6aa4
Upper Limb Robotic Therapy for
Children with Hemiplegia
ABSTRACT
Fasoli SE, Fragala-Pinkham M, Hughes R, Hogan N, Krebs HI, Stein J: Upper
limb robotic therapy for children with hemiplegia. Am J Phys Med Rehabil
2008;87:929 –936.
Objective: Our aim was to examine the feasibility and effects of robotic
therapy for children with cerebral palsy and upper limb hemiplegia.
Design: A single group within-subjects design was used. Twelve chil-
dren aged 5–12 yrs with moderate to severe motor impairments partic-
ipated in 1-hr robotic therapy sessions, 2 times per week for 8 wks.
During each session, children used the paretic arm to perform 640
repetitive, goal-directed planar reaching movements, with robotic assis-
tance as needed. Primary outcomes were the Quality of Upper Extremity
Skills Test (QUEST) and the Fugl-Meyer Assessment upper limb subtest.
Secondary outcomes were the Modified Ashworth Scale, peak isometric
strength of shoulder and elbow muscles, and parent questionnaire scores.
Results: We found significant gains in total QUEST and Fugl-Meyer
Assessment scores at discharge and follow-up and in isometric strength of
elbow extensors at discharge. The parent questionnaire showed significant
improvements in “how much” and “how well” children used the paretic
arm during daily functional tasks at home.
Conclusion: Robotic therapy can provide new opportunities for im-
proving upper limb coordination and function in children with moderate to
severe impairments due to cerebral palsy or stroke.
Key Words: Robotic Therapy, Cerebral Palsy, Children, Hemiplegia
November 2008 Robotic Therapy for Children 929
ORIGINAL RESEARCH ARTICLE
Hemiplegia