Robotic technologies and rehabilitation: new tools for upper-limb therapy and assessment in chronic stroke.

BACKGROUND: The use of robotic technology for assessment has the potential to provide therapists with objective, accurate, repeatable measurements of subject's functions. However, despite the increasing number of clinical studies examining the effect of robotic training on stroke rehabilitation, body functions and structures assessment is typically carried out through traditional human-administered clinical impairment scales. AIM: The paper aims at providing a complete set of kinematic and dynamic indices for an objective measure of the effect of robot-aided therapy, and testing their correlation with clinical scales. DESIGN: An intervention pilot study applying robotic therapy was carried out. SETTING: The clinical study was focused on outpatients and was carried out at Università Campus Bio-Medico of Rome, Italy. POPULATION: Fifteen community-dwelling persons with chronic stroke met inclusion criteria and volunteered to participate. METHODS: Upper limb robotic therapy was administered to patients. Kinematic and dynamic performance indices were extracted from position and force data recorded with the InMotion2 robot. A linear regression analysis was carried out to study correlation with clinical scales to extract a core set of performance indicators. RESULTS: Robotic outcome measures showed a significant improvement of kinematic motor performance; the improvement of dynamic components was significant only in resistive motion and highly correlated with Motor Power. CONCLUSION: Preliminary results showed that arm motor functions and strength of the paretic arm can be objectively measured by means of the proposed bunch of robotic measures. Correlation with Motor Power was high, while correlation with Fugl-Meyer was moderate. CLINICAL REHABILITATION IMPACT: An improvement of clinical body functions assessment is expected in terms of objective, accurate and repeatable measurements of subject's performance during recovery.

A preliminary efficacy evaluation performed by opto-electronic plethysmography of asymmetric respiratory rehabilitation.

The aim of present work is to test an optoelectronic system as diagnostic device to preliminary assess the efficacy of asymmetric respiratory rehabilitation. The respiratory rehabilitation efficacy, in terms of tidal volume variations, has been assessed for 14 patients undergone left or right superior lobectomy. Tidal volume variations of six torso compartments have been measured in pre-surgery, post-surgery and post-rehabilitation phases. Significant difference of total chest wall tidal volume has not been observed between the three phases. Tidal volume differences have been observed between paretic and healthy side. Significant tidal volume increase has been observed for non-operated side between pre-surgery and postrehabilitation phases during quiet breathing, mean tidal volume increases of about 32%. Measurement results indicate that respiratory rehabilitation is more effective on non-operated side which, in turn, compensates the operated one. The optoelectronic plethysmograph appears to be a suitable instrument for evaluation of respiratory rehabilitation in case of respiratory volumes asymmetry.

A preliminary analysis of the effects of elliptinium on immune reactivities in mice.

The immune effects of Elliptinium (2-methyl-9-hydroxyellipticinium, 9-HME), a chemical recently shown to possess clinical antineoplastic activity, were investigated in mice. Primary antibody responses to T-dependent and T-independent antigens, DTH reactivity and responsiveness to mitogens were significantly depressed only by post treatment with single drug doses of at least 5 mg/kg i.v., i.e. doses clearly above those known to exert full antitumoral effectiveness and to induce lymphoid cell depletion in the same species. Only drug doses in the LD50 range (i.e. 10 mg/kg) reduced the capacity of NK cells and of activated macrophages to express non-specific cytotoxicity towards tumor target cells. When repeated dose regimens were used, significant immune depression was again seen at doses above those displaying chemotherapeutic activity. Data obtained suggest that at chemotherapeutically effective dosages 9-HME possesses in mice a comparatively low immunodepressive potential and that immune cells mediating natural host defence mechanisms appear especially resistant to this drug.