title: Robot-aided therapy for upper limbs in patients with stroke-related lesions. Brief report of a clinical experience.
abstract: This study was aimed at verifying the improvement on the motor impairment and functionality in 19 patients with chronic hemiparesis after stroke treated with a robot-aided rehabilitation protocol using the ReoGo™ system (Motorika Medical Ltd, Israel), and at evaluating the persistence of the effects after 1 month. The study also focused on the actual possibility of administering the robot-aided therapy with the ReoGo™ for the upper limbs and on the patients' degree of acceptance and compliance with the treatment. Subjects underwent an assessment prior to the start of the rehabilitation project (T-1), one at the start (T0), one at the end of the treatment (T1) and one after one month from the end of the treatment (T2). The following tests were administered: (i) Fugl-Meyer (FM) upper limb; Ashworth scale (AS); Functional Independence Measure (FIM™) (T-1 - T2); (ii) strength evaluation; Visual Analogue Scale (VAS) for pain; Frenchay Arm test (FAT); Box and Block test (BBT); Timed Up and Go (TUG) test (T0 - T2). Additionally, the Euro-QoL questionnaire and a VAS for the treatment satisfaction were administered to the subjects. Non-statistical difference of scores at T-1 and T0 on almost the entire battery of tasks suggested a stable patients' performance prior to the start of the rehabilitation. With the exception of the Medical Research Council (MRC) and the AS sub-scales measuring -as appropriate- strength and spasticity of the shoulder, triceps and wrist, all scores showed a significant increase between T0 and T1. The improvement on the pain could not be proved significant (p = 0.10). A significant increase between T0 and T2 was found for all assessment scores, with the exception of the MRC for external shoulder rotators (p = 0.05) and of the AS for shoulder (p = 0.32) and wrist (p = 0.08). Substantial stability was observed between T1 and T2. Patients were capable of completing the treatment and showed good participant satisfaction. This pilot study led to the finding of a clinical improvement and excellent patients compliance. It is possible that the learning process experienced by the patients was robot-dependent, especially in consideration of the general maintenance of the achievements observed on all activities.
authors.affiliation: Medicine Rehabilitation NOCSAE Hospital AUSL of Modena, Modena, Italy. federica.bovolenta@libero.it
authors.forename: Federica
authors.initials: F
authors.lastname: Bovolenta
authors.forename: Patrizio
authors.initials: P
authors.lastname: Sale
authors.forename: Valentina
authors.initials: V
authors.lastname: Dall'Armi
authors.forename: Pierina
authors.initials: P
authors.lastname: Clerici
authors.forename: Marco
authors.initials: M
authors.lastname: Franceschini
mesh_terms: D000328:Adult; D000368:Aged; D001132:Arm / Q000294:innervation / Q000503:physiopathology*; D005081:Exercise Therapy / Q000295:instrumentation; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods*; D010291:Paresis / Q000175:diagnosis / Q000503:physiopathology / Q000534:rehabilitation*; D010865:Pilot Projects; D012371:Robotics / Q000295:instrumentation / Q000379:methods; D020521:Stroke / Q000503:physiopathology; D000071939:Stroke Rehabilitation