Upper limb robot-assisted therapy in subacute and chronic stroke patients using an innovative end-effector haptic device: A pilot study.

BACKGROUND: Significant results have been shown when an upper limb robot-assisted rehabilitation is delivered to stroke patients. OBJECTIVE: To evaluate the effects of upper limb robot-assisted rehabilitation on motor recovery in stroke patients who underwent a treatment based on a haptic device. METHODS: Thirty-nine stroke patients (twenty-three subacute and sixteen chronic) underwent rehabilitation training by using MOTORE/Armotion haptic system. Thirteen healthy subjects were recruited for comparison purpose.The following clinical outcome measures were used: Chedoke-McMaster Stroke Assessment, Modified Ashworth Scale (MAS), Fugl-Meyer Assessment (FM), Medical Research Council, Motricity Index (MI), Box and Block Test (B&B) and Modified Barthel Index (mBI).The following parameters were computed: mean speed, maximum speed, mean time, path length, normalized jerk, mean force, mean error, mean energy expenditure and active patient-robot interaction percentage.The assessments were carried-out before and after treatment. RESULTS: Significant changes were observed in both groups in the FM, MI, B&B and mean speed. Significant changes were observed in mBI, mean time, mean force, mean energy expenditure and active patient-robot interaction percentage in subacute stroke patients. In chronic stroke patients significant changes were found on the MAS-elbow. CONCLUSIONS: The haptic device used is at least as effective as an existing device used in similar studies.

Robot-assisted upper limb rehabilitation in chronic stroke patients.

The goal of this study is to evaluate the effects of upper limb robot-assisted treatment in chronic post-stroke patients using clinical outcome measures and kinematic parameters. Thirty-two chronic stroke patients participated in the study. Fugl-Meyer (FM) Assessment scale and Motricity Index (MI) were used for clinical assessment, and a set of kinematic parameters was computed. A significant decrease in motor impairment after the robotassisted treatment (FM p<0.001 and MI p<0.001) was found. Movement mean velocity (p<0.001) and accuracy (p<0.05) increased. Robotic treatment is effective to reduce motor impairment in chronic stroke patients. The exclusive use of clinical scales do not provide an exhaustive evaluation of effectiveness of treatment and our study suggests that kinematic parameters should be computed as well.