title: Use of a robotic device for the rehabilitation of severe upper limb paresis in subacute stroke: exploration of patient/robot interactions and the motor recovery process.
abstract: This pioneering observational study explored the interaction between subacute stroke inpatients and a rehabilitation robot during upper limb training. 25 stroke survivors (age 55 ± 17 years; time since stroke, 52 ± 21 days) with severe upper limb paresis carried out 16 sessions of robot-assisted shoulder/elbow training (InMotion 2.0, IMT, Inc., MA, USA) combined with standard therapy. The values of 3 patient/robot interaction parameters (a guidance parameter: Stiffness, a velocity-related parameter: Slottime, and Robotic Power) were compared between sessions 1 (S1), 4 (S4), 8 (S8), 12 (S12), and 16 (S16). Pre/post Fugl-Meyer Assessment (FMA) scores were compared in 18 patients. Correlations between interaction parameters and clinical and kinematic outcome measures were evaluated. Slottime decreased at S8 (P = 0.003), while Guidance decreased at S12 (P = 0.008). Robotic Power tended to decrease until S16. FMA scores improved from S1 to S16 (+49%, P = 0.002). Changes in FMA score were correlated with the Stiffness parameter (R = 0.4, P = 0.003). Slottime was correlated with movement velocity. This novel approach demonstrated that a robotic device is a useful and reliable tool for the quantification of interaction parameters. Moreover, changes in these parameters were correlated with clinical and kinematic changes. These results suggested that robot-based recordings can provide new insights into the motor recovery process.
authors.affiliation: CRF Les Trois Soleils, Médecine Physique et de Réadaptation, Unité de Rééducation Neurologique, 77310 Boissise-le-Roi, France.
authors.forename: Christophe
authors.identifier: 0000-0003-0318-8697
authors.initials: C
authors.lastname: Duret
authors.affiliation: CRF Les Trois Soleils, Médecine Physique et de Réadaptation, Unité de Rééducation Neurologique, 77310 Boissise-le-Roi, France.
authors.forename: Ophélie
authors.initials: O
authors.lastname: Courtial
authors.affiliation: CRF Les Trois Soleils, Médecine Physique et de Réadaptation, Unité de Rééducation Neurologique, 77310 Boissise-le-Roi, France.
authors.forename: Anne-Gaëlle
authors.initials: AG
authors.lastname: Grosmaire
authors.affiliation: Analyse et Restauration du Mouvement, Groupe Hospitalier Henri Mondor, Rééducation Neurolocomotrice, AP-HP, 94010 Créteil, France.
authors.forename: Emilie
authors.initials: E
authors.lastname: Hutin
mesh_terms: D001132:Arm / Q000503:physiopathology; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005260:Female; D006801:Humans; D008297:Male; D008328:Man-Machine Systems; D008875:Middle Aged; D010291:Paresis / Q000175:diagnosis / Q000503:physiopathology* / Q000534:rehabilitation*; D020127:Recovery of Function / Q000502:physiology*; D012371:Robotics / Q000295:instrumentation*; D020521:Stroke / Q000175:diagnosis / Q000503:physiopathology*; D000071939:Stroke Rehabilitation; D013813:Therapy, Computer-Assisted / Q000295:instrumentation; D016896:Treatment Outcome
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