title: Robotic techniques for upper limb evaluation and rehabilitation of stroke patients.
abstract: This paper presents two robot devices for use in the rehabilitation of upper limb movements and reports the quantitative parameters obtained to characterize the rate of improvement, thus allowing a precise monitoring of patient's recovery. A one degree of freedom (DoF) wrist manipulator and a two-DoF elbow-shoulder manipulator were designed using an admittance control strategy; if the patient could not move the handle, the devices completed the motor task. Two groups of chronic post-stroke patients (G1 n = 7, and G2 n = 9) were enrolled in a three week rehabilitation program including standard physical therapy (45 min daily) plus treatment by means of robot devices, respectively, for wrist and elbow-shoulder movements (40 min, twice daily). Both groups were evaluated by means of standard clinical assessment scales and a new robot measured evaluation metrics that included an active movement index quantifying the patient's ability to execute the assigned motor task without robot assistance, the mean velocity, and a movement accuracy index measuring the distance of the executed path from the theoretic one. After treatment, both groups improved their motor deficit and disability. In G1, there was a significant change in the clinical scale values (p < 0.05) and range of motion wrist extension (p < 0.02). G2 showed a significant change in clinical scales (p < 0.01), in strength (p < 0.05) and in the robot measured parameters (p < 0.01). The relationship between robot measured parameters and the clinical assessment scales showed a moderate and significant correlation (r > 0.53 p < 0.03). Our findings suggest that robot-aided neurorehabilitation may improve the motor outcome and disability of chronic post-stroke patients. The new robot measured parameters may provide useful information about the course of treatment and its effectiveness at discharge.
authors.affiliation: Service of Bioengineering, "Salvatore Maugeri" Foundation, IRCCS, 28010 Veruno, Italy. rcolombo@fsm.it
authors.forename: Roberto
authors.initials: R
authors.lastname: Colombo
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Pisano
authors.forename: Silvestro
authors.initials: S
authors.lastname: Micera
authors.forename: Alessandra
authors.initials: A
authors.lastname: Mazzone
authors.forename: Carmen
authors.initials: C
authors.lastname: Delconte
authors.forename: M Chiara
authors.initials: MC
authors.lastname: Carrozza
authors.forename: Paolo
authors.initials: P
authors.lastname: Dario
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Minuco
mesh_terms: D000368:Aged; D002908:Chronic Disease; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015915:Motion Therapy, Continuous Passive / Q000379:methods*; D009048:Motor Skills; D010291:Paresis / Q000175:diagnosis* / Q000209:etiology / Q000534:rehabilitation*; D010808:Physical Examination / Q000379:methods; D010812:Physical Stimulation / Q000379:methods; D012371:Robotics / Q000379:methods*; D020521:Stroke / Q000150:complications / Q000175:diagnosis*; D000071939:Stroke Rehabilitation; D013813:Therapy, Computer-Assisted / Q000379:methods*; D034941:Upper Extremity / Q000503:physiopathology