Validating ArmAssist Assessment as outcome measure in upper-limb post-stroke telerehabilitation

Abstract

The ArmAssist is a low-cost robotic system for post-stroke upper-limb telerehabilitation based on serious games. The system incorporates a set of games for the assessment of arm function, the ArmAssist Assessment (AAA), which allows a remote monitoring of the progress of the patient and an automatic adaptation of the therapy. In this study, different components of the AAA are compared against three widely-used clinical tests, the Fugl-Meyer Assessment (FMA) [1], the Action Research Arm Test (ARAT) [2] and the Wolf Motor Function Test (WMFT) [3] in order to select the most clinically meaningful ones for the final score provided to patients and therapist, and evaluate their capability to predict or even improve some aspects of these standard scales. All four tests were performed in 38 separate sessions in 19 post-stroke individuals in their sub-acute phase, as part of a broader study. Statistically significant correlation could be shown with the three clinical tests. These preliminary results are promising for the validation of AAA as a fast, automatic and clinically meaningful tool for remote progress assessment and therapy adaptation; however, more data and further analysis is needed to confirm this.

A serious game for virtual rehabilitation: evaluation with patients and physiotherapists

“…For the same purpose, low-cost robot-assistance is used in control games for training various tasks, using a platform that allows patients to adapt the therapy according to their needs [43]. In [44], a game to encourage gross movements was developed to improve the accuracy and speed of the upper limb movements, and also to improve visual discrimination and selective attention for post-stroke patients.…”

ArmAssist Robotic System versus Matched Conventional Therapy for Poststroke Upper Limb Rehabilitation: A Randomized Clinical Trial

“…The chair height was adjusted so the paretic forearm rests on the AA platform with the shoulder in a comfortable position. The AA-based assessment of range of motion and range of force was conducted twice a week (Monday, Friday) to adjust the game difficulty so the subject is challenged but still able to successfully complete the virtual task [ 12 ]. The AA robotic system does not have medical certification and has been used in this study as an investigational device.…”

“…The training games include complex tasks that require variable cognitive engagement designed to motivate the user to train longer and more effectively. The examples of training games include puzzles, memory, language, and card games [ 12 ]. The assessment games are short tasks (1 to 2 minutes) that evaluate different aspects of the upper limb motor control, such as the range and characteristics of movements with different degrees of freedom.…”

Development and implementation of technologies for physical telerehabilitation in Latin America:

“…In fact, some clinical studies reveal that only 31% of the patients actually follow home exercise routine such as prescribed by therapists [21]. Currently, home rehabilitation protocols are addressed to those patients in a game context, thus maintaining the effectiveness of cognitively challenging exercises [22]. For that reason, telerehabilitation systems based on motion capture have been shown to increase the intensity of rehabilitation sessions and improve the user's experience [23], [24].…”

“…They include both robotic devices and virtual reality applications for tele-homecare to coordinate in-home therapy and patient support, in-home patient telemonitoring, and teletherapy for exercise recognition and supervision by a remote therapist [22], [35], [36]. Specifically, a therapy robot is used during a rehabilitation program for a certain period of time to increase an individual's ability to recover the capability of movement [37].…”