10 - Transfer to Clinics

Question 1

Training intensity (arm)

Answer 1

• the more hours/week and/or the more intense, the better the results in ∆FM Fugl-Meyer score (arm training)
• increase
• – nbr of repetitions
• – physical effort (strength + assist as needed)
• – mental effort (task-specific, challenge, reward)

Question 2

Multicenter Randomized Clinical Trials (RCT)

Answer 2

Arm
- hyp: ARMin more effective
- primary / secondary outcome variables (FM / WFMT)
- inclusion criteria
- protocol = baseline - therapy - follow-up
- results: linear mixed effect model, no visible !=
Walking after stroke
- better outcomes? for whom?
- walking, velocity, capacity
- different effects with patient type but not so significant

Question 3

Evidence-based medicine (EBM)

Answer 3

• EBM is an approach to medical practice intended to optimize decision-making by emphasizing the use of evidence from well-designed and well-conducted research
• use of high quality clinical research in clinical decision making
• based on assessments

Question 4

Pros and cons robot-based assessment vs. conventional

Answer 4

+ qttv, more sensitive and accurate, comparable

• no stdization
• conventional is thoroughly tested and validated
• less easy to administer, cplx equipment

Question 5

A good assessment takes into account

Answer 5

• inter/intra rater variability
• test-retest variability
• ceiling/flooring effects
• internal consistency
• MDC = minimally detectable change
• MCID = minimally clinically important change

Question 6

Training efficiency

Answer 6

• efficiency = cost effectiveness
• with robots, 1 therapist can take care of more than 1 patient
• Eff(therapy) = Eff(therapist) x Eff(session)
  = t(training) x n(patient) / t(session) x n(therapist)

Question 7

Connection

Answer 7

• therapist (xp + human) + robot (endurance + force + repeatability) + patient
• social interaction and collaborative training