Translational effects of robot-mediated therapy in subacute stroke patients: an experimental evaluation of upper limb motor recovery

Abstract

Robot-mediated therapies enhance the recovery of post-stroke patients with motor deficits. Repetitive and repeatable exercises are essential for rehabilitation following brain damage or other disorders that impact the central nervous system, as plasticity permits to reorganize its neural structure, fostering motor relearning. Despite the fact that so many studies claim the validity of robot-mediated therapy in post-stroke patient rehabilitation, it is still difficult to assess to what extent its adoption improves the efficacy of traditional therapy in daily life, and also because most of the studies involved planar robots. In this paper, we report the effects of a 20-session-rehabilitation project involving the Armeo Power robot, an assistive exoskeleton to perform 3D upper limb movements, in addition to conventional rehabilitation therapy, on 10 subacute stroke survivors. Patients were evaluated through clinical scales and a kinematic assessment of the upper limbs, both pre- and post-treatment. A set of indices based on the patients’ 3D kinematic data, gathered from an optoelectronic system, was calculated. Statistical analysis showed a remarkable difference in most parameters between pre- and post-treatment. Significant correlations between the kinematic parameters and clinical scales were found. Our findings suggest that 3D robot-mediated rehabilitation, in addition to conventional therapy, could represent an effective means for the recovery of upper limb disability. Kinematic assessment may represent a valid tool for objectively evaluating the efficacy of the rehabilitation treatment.

Can kinematic parameters of 3D reach-to-target movements be used as a proxy for clinical outcome measures in chronic stroke rehabilitation? An exploratory study

“…Seminal work by Cirstea [ 36 ] showed a strong correlation between joint kinematics of 3D arm-reaching movements and FMA-UE scores. However, these results are in conflict with later studies showing moderate-to-poor associations between 3D arm-reaching kinematics and FMA-UE scores [ 37 – 39 ]. Other research of UE kinematics during the performance of simulated drinking from a glass [ 40 – 44 ] also reported moderate-to-poor correlations with clinical outcome measures of motor impairment and activity performance.…”

Upper limb motor improvement in chronic stroke after combining botulinum toxin A injection and multi-joints robot-assisted therapy: a case report

“…The device can support the patient’s UL weight, providing a feeling of fluctuation. The interface used for the exergame, is designed to simulate UL gestures and provide a simple virtual environment’ [10].…”

Kinematic Parameters for Tracking Patient Progress during Upper Limb Robot-Assisted Rehabilitation: An Observational Study on Subacute Stroke Subjects

“…The KPs have been moderately correlated to clinical outcome measures [15, 20, 24] and their validity and reliability have been established [40–42]. However, the majority of published studies employed KPs for assessing patient's status only at the beginning and at the end of the period of treatment [19–24, 26, 35–37]. However, robots for rehabilitation register data during each session of RT and thus allow day-to-day tracking of motor performance [16–18].…”