Effects of robot-assisted therapy on upper extremity function and activities of daily living in hemiplegic patients: A single-blinded, randomized, controlled trial

Lee, Min-Jae; Lee, Jung‐Hoon; Lee, Sun Min

doi:10.3233/thc-181336

Cited by 18 publications

(13 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Among the available wrist rehabilitative-devices and dose-matched conventional-intervention for rehabilitation of wrist in stroke, the reported gain in FMW/H is < 4 on a scale of 24 (12), (8), (26)(27)(28). In our study, the improvement in the FM score was ~14.…”

Section: Comparison Of Clinical-scales Of Robotic-therapy Group With mentioning

confidence: 43%

Evidence of Neuroplasticity With Robotic Hand Exoskeleton Study for Post-Stroke Rehabilitation: A Randomized Controlled Trial

Singh

Saini

Kumar

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: A novel electromechanical robotic-exoskeleton was designed in-house for rehabilitation of wrist joint and Metacarpophalangeal (MCP) joint. Objective: The objective was to compare the rehabilitation effectiveness (clinical-scales and neurophysiological-measures) of robotic-therapy training-sessions with dose-matched control in patients with stroke. Methods: A pilot prospective parallel single-blinded randomized controlled study at clinical-settings was designed with patients with stroke within 2 years of chronicity. Patients were randomly assigned to receive an intervention of 20 sessions of 45-minutes each, five days a week for four-weeks, in Robotic-therapy Group (RG) (n=12) and conventional upper-limb rehabilitation in Control-Group (CG) (n=11). We hypothesized to evaluate the exoskeleton based therapy for the effects on functionality of upper-limb and cortical-excitability in patients with stroke as compared to conventional-rehabilitation. Clinical-scales– Modified Ashworth Scale, Active Range of Motion, Barthel-Index, Brunstrom-stage and Fugl-Meyer scale (Shoulder/Elbow and Wrist/Hand component), and neurophysiological-measures of cortical-excitability (using Transcranial Magnetic Stimulation) –Motor Evoked Potential and Resting Motor-threshold, were acquired pre and post-therapy. No side effects were noticed in any of the patients. Results: RG and CG showed significant (p<0.05) improvement in all clinical motor-outcomes except Modified Ashworth Scale in CG. RG showed significantly (p<0.05) higher improvement over CG in Modified Ashworth Scale, Active Range of Motion and Fugl-Meyer (FM) scale and FM Wrist-/Hand component). Increase in cortical-excitability in ipsilesional-hemisphere was found to be statistically significant (p<0.05) in RG over CG, as indexed by decrease in Resting Motor-Threshold and increase in amplitude of Motor Evoked Potential. No significant changes were shown by the contralesional-hemisphere. Interhemispheric RMT-asymmetry evidenced significant (p<0.05) changes in RG over CG indicating increased cortical-excitability in ipsilesional-hemisphere along with interhemispheric changes. Conclusion: Neurophysiological-changes in RG could most likely be a consequence of plastic-reorganization and use-dependent plasticity. Robotic-exoskeleton training could significantly improve motor-outcomes and cortical-excitability in patients with stroke.

show abstract

Section: Comparison Of Clinical-scales Of Robotic-therapy Group With mentioning

confidence: 43%

Evidence of Neuroplasticity With Robotic Hand Exoskeleton Study for Post-Stroke Rehabilitation: A Randomized Controlled Trial

Singh

Saini

Kumar

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Patients in RG showed more participation in ADL, re ected by an increase in BI and AROM of the wrist (23). Among the available wrist rehabilitative-devices and dose-matched conventional-intervention for rehabilitation of wrist in stroke, the reported gain in FMW/H is < 4 on a scale of 24 (12), (8), (26)(27)(28). In our study, the improvement in the FM score was ~ 14.…”

Section: Comparison Of Clinical-scales Of Robotic-therapy Group With mentioning

confidence: 43%

Evidence of Neuroplasticity: A Robotic Hand Exoskeleton Study for Post-Stroke Rehabilitation

Singh¹,

Saini²,

Kumar³

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: A novel electromechanical robotic-exoskeleton was designed in-house for rehabilitation of wrist joint and Metacarpophalangeal (MCP) joint. Objective: The objective was to compare the rehabilitation effectiveness (clinical-scales and neurophysiological-measures) of robotic-therapy training-sessions with dose-matched control in patients with stroke. Methods: An observational pilot study was designed with patients within 2 years of chronicity. Patients received an intervention of 20 sessions of 45-minutes each, five days a week for four-weeks) in Robotic-therapy Group (RG) (n=12) and conventional upper-limb rehabilitation in Control-Group (CG) (n=11). Clinical-scales– Modified Ashworth Scale, Active Range of Motion, Barthel-Index, Brunstrom-stage and Fugl-Meyer scale (Shoulder/Elbow and Wrist/Hand component), and neurophysiological-measures of cortical-excitability (using Transcranial Magnetic Stimulation) –Motor Evoked Potential and Resting Motor-threshold, were acquired pre and post-therapy. Results: RG and CG showed significant improvement in all clinical motor-outcomes (p<0.05) except Modified Ashworth Scale in CG. RG showed significantly higher improvement over CG in Modified Ashworth Scale, Active Range of Motion and Fugl-Meyer (FM) scale and FM Wrist-/Hand component) (p<0.05). Increase in cortical-excitability in ipsilesional-hemisphere was found to be statistically significant in RG over CG, as indexed by decrease in Resting Motor-Threshold and increase in amplitude of Motor Evoked Potential (p<0.05). No significant changes were shown by the contralesional-hemisphere. Interhemispheric RMT-asymmetry evidenced significant changes in RG over CG (p<0.05) indicating increased cortical-excitability in ipsilesional-hemisphere along with interhemispheric changes.Conclusion: Neurophysiological-changes in RG could be most likely a consequence of plastic-reorganization and use-dependent plasticity. Robotic-exoskeleton training could significantly improve motor-outcomes and cortical-excitability in patients with stroke.Registry number: IEC/NP-99/13.03.2015

show abstract

“…With sparse literature exploring cortical-excitability changes in the lower-limb (33) and upper-limb (34), virtual mirror task with biofeedback observed an increased MEP by up to 46.3% (95% CI: 30.4∼80.0) compared with the real mirror task (34). The observed increase in FMW/H of patients with chronicstroke in robotic-assisted wrist-training and dose-matched conventional intervention was ≤4 (8,(35)(36)(37)(38), however, any direct comparison would be inappropriate considering different factors like chronicity, site of lesion, and age, etc.…”

Section: Changes In Fmri Activationsmentioning

confidence: 99%

A Case Report: Effect of Robotic Exoskeleton Based Therapy on Neurological and Functional Recovery of a Patient With Chronic Stroke

et al. 2021

View full text Add to dashboard Cite

Background: In this study, a novel electromechanical robotic exoskeleton was developed for the rehabilitation of distal joints. The objective was to explore the functional MRI and the neurophysiological changes in cortical-excitability in response to exoskeleton training for a 9-year chronic stroke patient.Case-Report: The study involved a 52-year old female patient with a 9-year chronic stroke of the right hemisphere, who underwent 20 therapy sessions of 45 min each. Cortical-excitability and clinical-scales: Fugl-Mayer (FM), Modified Ashworth Scale (MAS), Brunnstrom-Stage (BS), Barthel-Index (BI), Range of Motion (ROM), were assessed pre-and post-therapy to quantitatively assess the motor recovery.Clinical Rehabilitation Impact: Increase in FM wrist/hand by 6, BI by 10, and decrease in MAS by 1 were reported. Ipsilesional Motor Evoked Potential (MEP) (obtained using Transcranial Magnetic Stimulation) was increased by 98 μV with a decrease in RMT by 6% and contralesional MEP was increased by 43 μV with a decrease in RMT by 4%. Laterality Index of Sensorimotor Cortex (SMC) reduced in precentral- gyrus (from 0.152 to −0.707) and in postcentral-gyrus (from 0.203 to −0.632).Conclusion: The novel exoskeleton-based training showed improved motor outcomes, cortical excitability, and neuronal activation. The research encourages the further investigation of the potential of exoskeleton training.

show abstract

Effects of robot-assisted therapy on upper extremity function and activities of daily living in hemiplegic patients: A single-blinded, randomized, controlled trial

Abstract: The findings from this study showed that combining robot-assisted therapy with general occupational therapy may enhance upper-extremity function and the ability to perform ADL in patients with stroke-induced hemiplegia compared to those obtained with general occupational therapy alone.

Cited by 18 publications

References 19 publications

Evidence of Neuroplasticity With Robotic Hand Exoskeleton Study for Post-Stroke Rehabilitation: A Randomized Controlled Trial

Evidence of Neuroplasticity With Robotic Hand Exoskeleton Study for Post-Stroke Rehabilitation: A Randomized Controlled Trial

Evidence of Neuroplasticity: A Robotic Hand Exoskeleton Study for Post-Stroke Rehabilitation

A Case Report: Effect of Robotic Exoskeleton Based Therapy on Neurological and Functional Recovery of a Patient With Chronic Stroke

Contact Info

Product

Resources

About