Effectiveness and Superiority of Rehabilitative Treatments in Enhancing Motor Recovery Within 6 Months Poststroke: A Systemic Review

Lin, I-Hsien; Tsai, Han-Ting; Wang, Chien-Yung; Hsu, Chih‐Yang; Liou, Tsan Hon; Lin, Yen-Nung

doi:10.1016/j.apmr.2018.09.123

Cited by 38 publications

(35 citation statements)

References 152 publications

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“…This was reflected in an effect size in favor of the R_Group (Cohen's d = 0.35) although the difference was not statistically significant. Noteworthy, this FM-UE effect size was comparable or superior to values reported by recent reviews on robot therapy versus physiotherapy without technological devices (Cohen's d between 0.12 and 0.39 [16,17,87]). The result was confirmed considering both dosematched (Cohen's d = 0.23 [16]) and non-dose-matched trials (Cohen's d = 0.08 [16]).…”

Section: Effects Of Robot Therapy Versus Arm-specific Physiotherapy Osupporting

confidence: 78%

Effects of robot therapy on upper body kinematics and arm function in persons post stroke: a pilot randomized controlled trial

Carpinella

Lencioni

Bowman

et al. 2020

J NeuroEngineering Rehabil

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Background: Robot-based rehabilitation for persons post-stroke may improve arm function and daily-life activities as measured by clinical scales, but its effects on motor strategies during functional tasks are still poorly investigated. This study aimed at assessing the effects of robot-therapy versus arm-specific physiotherapy in persons post-stroke on motor strategies derived from upper body instrumented kinematic analysis, and on arm function measured by clinical scales.Methods: Forty persons in the sub-acute and chronic stage post-stroke were recruited. This sample included all those subjects, enrolled in a larger bi-center study, who underwent instrumented kinematic analysis and who were randomized in Center 2 into Robot (R_Group) and Control Group (C_Group). R_Group received robot-assisted training. C_ Group received arm-specific treatment delivered by a physiotherapist. Pre-and post-training assessment included clinical scales and instrumented kinematic analysis of arm and trunk during a virtual untrained task simulating the transport of an object onto a shelf. Instrumented outcomes included shoulder/elbow coordination, elbow extension and trunk sagittal compensation. Clinical outcomes included Fugl-Meyer Motor Assessment of Upper Extremity (FM-UE), modified Ashworth Scale (MAS) and Functional Independence Measure (FIM). Results: R_Group showed larger post-training improvements of shoulder/elbow coordination (Cohen's d = − 0.81, p = 0.019), elbow extension (Cohen's d = − 0.71, p = 0.038), and trunk movement (Cohen's d = − 1.12, p = 0.002). Both groups showed comparable improvements in clinical scales, except proximal muscles MAS that decreased more in R_Group (Cohen's d = − 0.83, p = 0.018). Ancillary analyses on chronic subjects confirmed these results and revealed larger improvements after robot-therapy in the proximal portion of FM-UE (Cohen's d = 1.16, p = 0.019). Conclusions: Robot-assisted rehabilitation was as effective as arm-specific physiotherapy in reducing arm impairment (FM-UE) in persons post-stroke, but it was more effective in improving motor control strategies adopted during an untrained task involving vertical movements not practiced during training. Specifically, robot therapy induced larger improvements of shoulder/elbow coordination and greater reduction of abnormal trunk sagittal movements. The beneficial effects of robot therapy seemed more pronounced in chronic subjects. Future studies on a larger sample should be performed to corroborate present findings. Trial registration: www.ClinicalTrials.gov NCT03530358. Registered 21 May 2018. Retrospectively registered.

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Section: Effects Of Robot Therapy Versus Arm-specific Physiotherapy Osupporting

confidence: 78%

Effects of robot therapy on upper body kinematics and arm function in persons post stroke: a pilot randomized controlled trial

Carpinella

Lencioni

Bowman

et al. 2020

J NeuroEngineering Rehabil

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“…Robotic-assisted rehabilitation is becoming an increasingly popular form of treatment, also for stroke patients. According to Lin's et al [110] definition, "robotic devices use end-effectors, exoskeletons, or harnesses to guide or assist the planned motions, enabling high training intensity (e.g., high repetitions of movements)". In stroke patients, these devices are used in both the upper limb's rehabilitation [78] and to improve the function of the lower limb -primarily to improve gait [79].…”

Section: Roboticsmentioning

confidence: 99%

Pharmacological Interventions and Rehabilitation Approach for Enhancing Brain Self-repair and Stroke Recovery

Szelenberger

Kostka

Saluk‐Bijak

et al. 2019

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Neuroplasticity is a natural process occurring in the brain for the entire life. Stroke is the leading cause of long term disability and a huge medical and financial problem throughout the world. Research conducted over the past decade focused mainly on neuroprotection in the acute phase of stroke while very little studies target the chronic stage. Recovery after stroke depends on the ability of our brain to reestablish the structural and functional organization of neurovascular networks. Combining adjuvant therapies and drugs may enhance the repair processes and restore impaired brain functions. Currently, there are some drugs and rehabilitative strategies that can facilitate brain repair and improve clinical effect even years after stroke onset. Moreover, some of the compounds such as citicoline, fluoxetine, niacin, levodopa, etc. are already in clinical use or are being trialed in clinical issues. Many studies are also testing cell therapies; in our review, we focused on studies where cells have been implemented at the early stage of stroke. Next, we discuss pharmaceutical interventions. In this section, we selected methods of cognitive, behavioral, and physical rehabilitation as well as adjuvant interventions for neuroprotection including noninvasive brain stimulation and extremely low-frequency electromagnetic field. The modern rehabilitation represents a new model of physical interventions with the limited therapeutic window up to six months after stroke. However, previous studies suggest that the time window for stroke recovery is much longer than previously thought. This review attempts to present the progress in neuroprotective strategies, both pharmacological and non-pharmacological that can stimulate the endogenous neuroplasticity in post-stroke patients.

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“…an increasingly useful tool to overcome the lack of human and economic resources associated with rehabilitation medicine, the clinical efficacy of VR rehabilitation compared with traditional training techniques remains to be elucidated. [1][2][3][4][5][6][7][8]…”

Section: Case Report Virtual Reality-guided Dual-task Body Trunk Bamentioning

confidence: 99%

“…Balance is essential for walking, and walking ability is a critical basic function associated with the quality of life. [1][2][3][4][5] Walking is a harmonized physical activity requiring (1) lower-extremity muscle strength, (2) postural or trunk balancing ability, and (3) dual-task processing. [5][6][7][8] Whereas lower-extremity muscle strength can be increased by various methods, no effective quantitative approach has been identified to train for balance and dual-task processing skills with the subject in the sitting position.…”

Section: Introductionmentioning

confidence: 99%

Virtual Reality-guided, Dual-task, Body Trunk Balance Training in the Sitting Position Improved Walking Ability without Improving Leg Strength

Omon

Hara

Ishikawa

2019

PRM

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Effectiveness and Superiority of Rehabilitative Treatments in Enhancing Motor Recovery Within 6 Months Poststroke: A Systemic Review

Cited by 38 publications

References 152 publications

Effects of robot therapy on upper body kinematics and arm function in persons post stroke: a pilot randomized controlled trial

Effects of robot therapy on upper body kinematics and arm function in persons post stroke: a pilot randomized controlled trial

Pharmacological Interventions and Rehabilitation Approach for Enhancing Brain Self-repair and Stroke Recovery

Virtual Reality-guided, Dual-task, Body Trunk Balance Training in the Sitting Position Improved Walking Ability without Improving Leg Strength

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