Do all sub acute stroke patients benefit from robot-assisted therapy? A retrospective study

Abstract

Purpose: Upper limb robot-assisted rehabilitation is a highly intensive therapy, mainly recommended after stroke. Whether robotic therapy is suitable for subacute patients with severe impairments including cognitive disorders is unknown. This retrospective study explored factors impacting on motor performance achieved in a 16-session robotic training combined with standard rehabilitation. Methods: Seventeen subacute inpatients (age 53 ± 18; 49 ± 26 days post-stroke) were assessed at baseline using upper extremity motor impairments scales, Functional Independence Measure, aphasia and neglect scores. Number of movements and robotic assistance were compared between Session 2 (S2), 8 (8) and 16 (S16), Motricity Index between pre and post-treatment. Correlation analyses explored predictors of motor performance. Results: Overall, number of movements and Motricity Index increased significantly while robot-assistance decreased. The mean number of movements per session correlated positively with baseline motor capacities but not with age, aphasia and neglect. However, the increase in Motricity index correlated negatively with baseline Motricity index and the increase in the number of movements correlated negatively with the number of movements at S2. Conclusion: High intensity robot-assisted training may be associated with motor improvement in subacute hemiparesis. More severely impaired patients may derive greater benefit from robot-assisted training; age, aphasia and neglect do not represent exclusion criteria.

Is Unilateral Spatial Neglect Associated With Motor Recovery of the Affected Upper Extremity Poststroke? A Systematic Review

“…A total of 850 studies were identified, 34 full texts were assessed for eligibility, and a total of 14 studies were included in this systematic review (see Figure 1, the PRISMA chart). A total of 13 studies 14,23,[33][34][35][36][37][38][39][40][41][42][43] included testing of correlations between USN and the affected UE capacity or recovery; of these, 11 studies 14,23,[33][34][35][36][37][38][39][40][41] were observational studies, and 2 studies 42,43 were a secondary analysis of an experimental design. Only 1 of the 14 included studies specifically researched the effect of an UE intervention provided to participants with USN.…”

Predictors of activities of daily living outcomes after upper limb robot-assisted therapy in subacute stroke patients

“…On the other hand, our findings are in disagreement with Duret et al . [ 24 ], who found a negative correlation between MIul at T2 and MIul at T1. The reasons of such discrepancy can be found in the different sample sizes and in the different nature of the primary outcomes (our primary outcome is ADL, Duret’s primary outcome was motor function).…”

“…A systematic review [ 16 ] on predictors of upper limb recovery after traditional arm therapy analysed several studies on this topic, and affirmed that measures of upper limb impairment and function were the most significant predictors (less impairment is associated with better recovery). However, literature on predictors of upper limb recovery after RT is limited and controversial [ 20 , 21 , 22 , 23 , 24 ].…”

“…Conversely, Duret et al . [ 28 ] reported that severely motor impaired patients may benefit more from RT. These results were obtained from a retrospective study on 17 patients, who conducted 20 sessions of upper limb RT with InMotion 2.0 robot.…”

Robotic gaming prototype for upper limb exercise: Effects of age and embodiment on user preferences and movement

“…This has led to growing interest in developing devices that support the rehabilitation process and increase patients’ motivation ( Bertani et al, 2017 ; Fasola & Mataric, 2012 ; Maciejasz et al, 2014 ; Schoone et al, 2007 ). How to integrate productive rehabilitation tasks with motivational features is an especially challenging open question ( Duret et al, 2015 ; Nordin et al, 2014 ).…”