Upper limb robot-assisted therapy in subacute and chronic stroke patients: Preliminary results on initial exposure based on kinematic measures

Mazzoleni, Stefano; Buono, Lorenzo; Dario, P.; Posteraro, Federico

doi:10.1109/biorob.2014.6913787

Cited by 8 publications

(9 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…To this extent, Mazzoleni et al [27] analysed KPs registered by 25 subacute stroke subjects during RT with a planar end-effector robot and found that kinematics significantly improved in the first sessions of treatment, and that a plateau occurred after 10 th session. These results were confirmed in a subsequent study by the same group on 12 subacute and 12 chronic stroke patients [31]. These outcomes were encouraging although a restricted number of patients was recruited, and the analysis of KPs did not investigate whether the recovery was dependent from the direction of the movement.…”

Section: Introductionmentioning

confidence: 69%

“…To our knowledge, only Panarese et al [30] analysed the submovements, each in a different direction, finding that motor recovery was direction-dependent. Other published studies are aimed at understanding whether built-in movement measures could be employed in clinical practice for optimizing the length of poststroke RT [27, 31]. To this extent, Mazzoleni et al [27] analysed KPs registered by 25 subacute stroke subjects during RT with a planar end-effector robot and found that kinematics significantly improved in the first sessions of treatment, and that a plateau occurred after 10 th session.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

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

Goffredo

Mazzoleni

Gison

et al. 2019

Applied Bionics and Biomechanics

View full text Add to dashboard Cite

Background Upper limb robot-assisted therapy (RT) provides intensive, repetitive, and task-specific treatment, and its efficacy for stroke survivors is well established in literature. Biomechanical data from robotic devices has been widely employed for patient's assessment, but rarely it has been analysed for tracking patient progress during RT. The goal of this retrospective study is to analyse built-in kinematic data registered by a planar end-effector robot for assessing the time course of motor recovery and patient's workspace exploration skills. A comparison of subjects having mild and severe motor impairment has been also conducted. For that purpose, kinematic data recorded by a planar end-effector robot have been processed for investigating how motor performance in executing point-to-point trajectories with different directions changes during RT. Methods Observational retrospective study of 68 subacute stroke patients who conducted 20 daily sessions of upper limb RT with the InMotion 2.0 (Bionik Laboratories, USA): planar point-to-point reaching tasks with an “assist as needed” strategy. The following kinematic parameters (KPs) were computed for each subject and for each point-to-point trajectory executed during RT: movement accuracy, movement speed, number of peak speed, and task completion time. The Wilcoxon signed-rank tests were used with clinical outcomes. the Friedman test and post hoc Conover's test (Bonferroni's correction) were applied to KPs. A secondary data analysis has been conducted by comparing patients having different severities of motor impairment. The level of significance was set at p value < 0.05. Results At the RT onset, the movements were less accurate and smoothed, and showed higher times of execution than those executed at the end of treatment. The analysis of the time course of KPs highlighted that RT seems to improve the motor function mainly in the first sessions of treatment: most KPs show significant intersession differences during the first 5/10 sessions. Afterwards, no further significant variations occurred. The ability to perform movements away from the body and from the hemiparetic side remains more challenging. The results obtained from the data stratification show significant differences between subjects with mild and severe motor impairment. Conclusion Significant improvements in motor performance were registered during the time course of upper limb RT in subacute stroke patients. The outcomes depend on movement direction and motor impairment and pave the way to optimize healthcare resources and to design patient-tailored rehabilitative protocols.

show abstract

Section: Introductionmentioning

confidence: 69%

Section: Introductionmentioning

confidence: 99%

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

Goffredo

Mazzoleni

Gison

et al. 2019

Applied Bionics and Biomechanics

View full text Add to dashboard Cite

show abstract

“…Acceleration presents few reports of changes after post-stroke therapeutic interventions despite being an important aspect analyzed in kinematic evaluations [21,25,26]. This measure reflects the smoothness of motor activity and implies faster movement onset and greater motor control throughout the action [11,[27][28][29].…”

Section: Discussionmentioning

confidence: 99%

“…In this study, we also related the results of TDAI with the conventional clinical tests, but few correlations were observed. We credit this to the fact that the evaluated aspects of human movement are different from those measured, since conventional clinical instruments have results on ordinal scales (REACH and ARAT) or number of cubes transported (BBT), while the device has numerical results corresponding to temporal variables [27,32,33].…”

Section: Discussionmentioning

confidence: 99%

Low-cost equipment for the evaluation of reach and grasp in post-stroke individuals: a pilot study

et al. 2020

View full text Add to dashboard Cite

Background: Reach-grasp movements are motor components commonly affected after stroke and directly related to the independence of these individuals. Evaluations of these activities can be performed using clinical instruments and assessed by detailed and costly kinematic analyses. The aim of this study was to develop an analysis of reach-grasp movements in post-stroke patients using a simple, inexpensive, and manageable instrument. Results:A Mann-Whitney test was used to compare paretic and non-paretic limb motor performance. A statistically significant difference was found between the variables of total time (p = 0.02) and speed to reach target 3 (p = 0.04) for task 1, while in task 2 significance was found only in the aspect of speed to reach target 2 (p = 0.04). The correlation between clinical tests and variables of tasks was then performed using Spearman's rank correlation coefficient. At task 1, when compared with the REACH instrument, the close target sub-item; there was a high positive correlation between the parameters of total time (p = 0.028), target velocity 3 (p = 0.028), and target acceleration 3 (p = 0.028). Another instrument that showed a high positive correlation with the target time 3 (p = 0.01) and target acceleration 3 (p = 0.028) variables was the Box and Block Test. When correlated, the data between the task 2 variables and clinical instruments did not present statistically significant data. Conclusion:Our instrument-the Temporal Data Acquisition Instrument-TDAIfulfilled the expected objectives and can be used as an option to evaluate the movements of reach and grasp of upper limb post-stroke, using an easy and fast application, without the need for calibration. retrospectively registered (http:// www.ensai oscli nicos .gov.br/rg/RBR-4995c r/)

show abstract

“…More relevant to rehabilitation robotics, this framework has been shown to apply even in severely impaired individuals: movement onset and cessation is from rest or at low speed if transitioning in a movement re-direction; velocity profiles are typically single or multiple peaked (Trombly, 1993;Cirstea and Levin, 2000;Rohrer et al, 2002;Wininger et al, 2009). To wit, this principle is embedded in robot-based assistive technology (Patton and Mussa-Ivaldi, 2004;Kahn et al, 2006;Velliste et al, 2008;Mazzoleni et al, 2014). And while not an explicit requirement for our algorithm, we note that a bell-shaped velocity profile is typical of a healthy actor, and conformity to a bell-shaped template is an indication of motoric recovery (Trombly, 1993;Rohrer et al, 2002).…”

Section: Key Assumptionmentioning

confidence: 99%

A Partitioning Algorithm for Extracting Movement Epochs from Robot-Derived Kinematic Data

et al. 2017

View full text Add to dashboard Cite

Point-to-point exercising of the upper-limb, as elicited through the presentation of visual targets on a computer screen, is a ubiquitous paradigm in the robot-assisted rehabilitation of motor-impaired individuals. Kinematic data collected from the robot's sensors can be used to assess motor function; these data allow objective quantification of motor performance, an approach that shows promise both for guiding therapy and documenting patient progress. It is imperative that these datasets be fully understood and that tools be continually developed to support analysis and proper interpretation of robot-generated data. It is our experience that data collected from kinematic robots and partitioned according to target achievement may be prone to errors in analysis and interpretation because the movements of highly spastic individuals rarely stop within the target. Here, we propose that it is preferable to partition serial movement data based on local minima in velocity rather than target achievement; this design reflects the convention that movement epochs start and end at low or zero velocity, an assumption that is prevalent even in severely impaired individuals. Using a commercially available robot (MIT-Manus, Interactive Motion Technologies), we recorded movements from 16 moderate to severely impaired chronic stroke patients. Data partitioned according to target presentation typically interrupted movements in mid-motion: velocity at file start was 32.6 ± 26.4% of the overall velocity range. By re-apportioning, we obtained velocity at file start of 7.4 ± 9.5% of total range. Across 3,200 movements, 12.4 ± 10.4% of data points were re-allocated on average. Thus, our routine is capable of re-partitioning to more accurately reflect observed behavior. Our study is thus the first to identify and propose a solution to the problem of high relevance to the community of robot-aided rehabilitation specialists, i.e., suboptimal partitioning according to target achievement. Through the algorithm described in this paper, we were able to re-partition the data so that movement epochs were properly demarcated at velocity minima, thus adhering to the fundamental assumptions of human motor behavior and facilitating analysis of patient performance on a per-movement basis.

show abstract

Upper limb robot-assisted therapy in subacute and chronic stroke patients: Preliminary results on initial exposure based on kinematic measures

Cited by 8 publications

References 16 publications

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

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

Low-cost equipment for the evaluation of reach and grasp in post-stroke individuals: a pilot study

A Partitioning Algorithm for Extracting Movement Epochs from Robot-Derived Kinematic Data

Contact Info

Product

Resources

About