Arm-Training with T-WREX After Chronic Stroke: Preliminary Results of a Randomized Controlled Trial

Abstract

This study presents preliminary results of a randomized controlled trial comparing a novel passive arm orthosis training system, the Therapy Wilmington Robotic Exoskeleton (T-WREX), with conventional self-directed upper extremity exercises. Chronic stroke survivors (n = 23) with moderate to severe upper limb hemiparesis trained three times per week for eight weeks with minimal supervision from an occupational therapist. Both groups demonstrated significant improvements in arm movement ability according to the Fugl-Meyer (3.7 point mean improvement in T-WREX group, p = 0.001, and 2.7 point improvement in control group, p = 0.003). Individuals who completed T-WREX training also demonstrated significant gains in self-rated quality of arm movement on the Motor Activity Log (p=0.05), and showed a trend towards greater gains on all clinical measures, although this trend was not significant at the current study size. Post-treatment surveys revealed a subjective preference for T-WREX training over conventional gravity-supported exercises. These preliminary results suggest that the T-WREX is a safe device feasible for clinical use, and effective in enhancing upper extremity motor recovery and patient motivation. Next steps are discussed.