Using robot fully assisted functional movements in upper-limb rehabilitation of chronic stroke patients: preliminary results.
BACKGROUND
Robotic rehabilitation is promising to promote function in stroke patients. The assist as needed training paradigm has shown to stimulate neuroplasticity but often cannot be used because stroke patients are too impaired to actively control the robot against gravity.


OBJECTIVE
To verify whether a rehabilitation intervention based on robot fully assisted reaching against gravity (RCH) and hand-to-mouth (HTM) can promote upper-limb function in chronic stroke.


METHODS
Cohort study.


METHODS
Chronic stroke outpatients referring to the robotic rehabilitation lab of a rehabilitation centre.


METHODS
Ten chronic stroke patients with mild to moderate upper-limb hemiparesis.


METHODS
Patients underwent 12 sessions (3 per week) of robotic treatment using an end-effector robot Every session consisted of 20 minutes each of RCH and HtM; movements were fully assisted, but patients were asked to try to actively participate. The Fugl-Meyer Assessment (FMA) was the primary outcome measure; Medical Research Council and Modified Ashworth Scale were the secondary outcome measures.


RESULTS
All patients, but one, show functional improvements (FMA section A-D, mean increment 7.2±3.9 points, P<0.008).


CONCLUSIONS
This preliminary study shows that a robotic intervention based on functional movements, fully assisted, can be effective in promoting function in chronic stroke patients. These results are promising considering the short time of the intervention (1 month) and the time from the stroke event, which was large (27±20 months). A larger study, comprehensive of objective instrumental measures, is necessary to confirm the results.


CONCLUSIONS
This intervention could be extended even to subacute stroke and other neurological disorders.
Institute of Industrial Technology and Automation (ITIA), Consiglio Nazionale delle Ricerche (CNR), Milan, Italy - marco.caimmi@itia.cnr.it.
Marco
M
Caimmi
Institute of Industrial Technology and Automation (ITIA), Consiglio Nazionale delle Ricerche (CNR), Milan, Italy.
Andrea
A
Chiavenna
Institute of Industrial Technology and Automation (ITIA), Consiglio Nazionale delle Ricerche (CNR), Milan, Italy.
Alessandro
A
Scano
Villa Beretta Rehabilitation Centre, Costamasnaga, Lecco, Italy.
Giulio
G
Gasperini
Villa Beretta Rehabilitation Centre, Costamasnaga, Lecco, Italy.
Chiara
C
Giovanzana
Institute of Industrial Technology and Automation (ITIA), Consiglio Nazionale delle Ricerche (CNR), Milan, Italy.
Lorenzo
L
Molinari Tosatti
Villa Beretta Rehabilitation Centre, Costamasnaga, Lecco, Italy.
Franco
F
Molteni
D000328:Adult; D000368:Aged; D002908:Chronic Disease; D015331:Cohort Studies; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010291:Paresis / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D020127:Recovery of Function; D012371:Robotics; D020521:Stroke / Q000150:complications* / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome; D034941:Upper Extremity; D055815:Young Adult