Stroke Rehabilitation in Frail Elderly with the Robotic Training Device ACRE: A Randomized Controlled Trial and Cost-Effectiveness Study

Abstract

The ACRE (ACtive REhabilitation) robotic device is developed to enhance therapeutic treatment of upper limbs after stroke. The aim of this study is to assess effects and costs of ACRE training for frail elderly patients and to establish if ACRE can be a valuable addition to standard therapy in nursing home rehabilitation. The study was designed as randomized controlled trial, one group receiving therapy as usual and the other receiving additional ACRE training. Changes in motor abilities, stroke impact, quality of life and emotional well-being were assessed. In total, 24 patients were included. In this small number no significant effects of the ACRE training were found. A large number of 136 patients were excluded. Main reasons for exclusion were lack of physiological or cognitive abilities. Further improvement of the ACRE can best be focused on making the system suitable for self-training and development of training software for activities of daily living.

Challenges in Seniors Adopting Assistive Robots: A Systematic Review

“…Lo et al 17 found the average total costs of 36 weeks of robot-assisted versus intensive therapy were $17,831 and $19,746, respectively. In contrast, a six-week study by Schoone et al 14 showed that a rehabilitation robot called ACRE, for enhancing upper limb therapy services, was more expensive than conventional care, at €644.41 vs. €423.74. A possible solution to this issue is to create two versions of rehabilitation robots: 1) a comprehensive and adaptable version for large rehabilitation centers and 2) a low-cost, simplified version for residential use.…”

“…5 Findings have shown that seniors preferred to have rehabilitation robots with simple features to support their physical disabilities. 5,10,[13][14] In the case of mobility problems due to aging, seniors may benefit from power or robotic wheelchairs. 10 In experiments with a robotic wheelchair called CARMEN, older volunteers stated that they could easily control the robotic wheelchair and preferred it over a conventional power wheelchair (PW).…”

“…14 As a consequence, seniors were able to perform full-range movements. 14 The latest trend in rehabilitation robots is the capability of a robot to learn new techniques and to detect and recognize objects. 5 Some of the latest developments are haptic interfaces, voice and facial recognition, mood and emotional state recognition.…”

“…If a person is suffering a chronic disease (for example dementia), they will be much more open to adopting and using rehabilitation robots for cognitive therapy. 16 In a study conducted by Schoone et al, 14 therapeutic treatment of upper limbs was performed using the ACRE robotic device while a therapist sat next to participants to ensure the therapy treatment was safe and effective. This means seniors without prior knowledge of rehabilitation robots were still able to perform rehabilitative training through the use of a robot.…”

Frailty Care Robot for Elderly and its Application for Physical and Psychological Support

“…For physical frailty care, both physical abilities and health are to be considered. Robotic rehabilitation support has been proposed for the care of physical abilities [3]. Health support through interaction with robots is effec-tive [4], and a personal healthcare companion robot Mabu was released [5].…”