Robotic technologies and rehabilitation: new tools for upper-limb therapy and assessment in chronic stroke.
ABSTRACT 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.
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.
An intervention pilot study applying robotic therapy was carried out.
The clinical study was focused on outpatients and was carried out at Università Campus Bio-Medico of Rome, Italy.
Fifteen community-dwelling persons with chronic stroke met inclusion criteria and volunteered to participate.
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.
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.
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.
An improvement of clinical body functions assessment is expected in terms of objective, accurate and repeatable measurements of subject's performance during recovery.
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ABSTRACT: This paper is focused on the multimodal analysis of patient performance, carried out by means of robotic technology and wearable sensors, and aims at providing quantitative measure of biomechanical and motion planning features of arm motor control following rehabilitation. Upper-limb robotic therapy was administered to 24 community-dwelling persons with chronic stroke. Performance indices on patient motor performance were computed from data recorded with the InMotion2 robotic machine and a magneto-inertial sensor. Motor planning issues were investigated by means of techniques of motion decomposition into submovements. A linear regression analysis was carried out to study correlation with clinical scales. Robotic outcome measures showed a significant improvement of kinematic motor performance; improvement of dynamic components was more significant in resistive motion and highly correlated with MP. The analysis of motion decomposition into submovements showed an important change with recovery of submovement number, amplitude and order, tending to patterns measured in healthy subjects. Preliminary results showed that arm biomechanical functions can be objectively measured by means of the proposed set of performance indices. Correlation with MP is high, while correlation with FM is moderate. Features related to motion planning strategies can be extracted from submovement analysis.Medical & Biological Engineering 07/2011; 49(10):1131-44. DOI:10.1007/s11517-011-0808-1 · 1.50 Impact Factor
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ABSTRACT: OBJECTIVE: To evaluate the efficacy of a gravity-supported, computer-enhanced device (Armeo(®)Spring) for upper limb rehabilitation in chronic stroke patients. MATERIAL AND METHODS: We included 23 chronic hemiparetic patients (chronicity: 328 ± 90.8 days; distribution: 17 men and 6 women) aged 54.6 ± 9.5 years, who had sustained ischaemic (n=12) or haemorrhagic (n=11) stroke. All patients completed 36 one-hour sessions using the Armeo(®)Spring system. Arm movement was assessed at the beginning and end of the treatment programme, and once more 4 months later. Main outcome measurements covered structure, activity, and function, as per the International Classification of Functioning, Disability and Health: Modified Ashworth Scale, Motricity Index (MI), Fugl-Meyer Assessment Scale (FM), Motor Assessment Scale (MAS), Manual Function Test (MFT), and Wolf Motor Function Test (WMFT). RESULTS: Repeated measures ANOVA showed significant improvement (time effect) for all function scales (P<.01 for FM and MI) and activity scales (P<.01 for MAS, MFT and WMFT-ability, and P<.05 WMFT-time) without significant changes in muscle tone. The post-hoc analysis (Bonferroni) showed different evolutionary patterns for function and activity measurements, and clear benefits related to Armeo(®)Spring training, especially on activity scales. CONCLUSIONS: Armeo(®)Spring is an effective tool for rehabilitating the affected arm in patients with hemiparesis secondary to ictus, even in the chronic stage.Neurologia 06/2012; 28(5). · 1.35 Impact Factor
Conference Paper: Patient-tailored adaptive robotic system for upper-limb rehabilitation[Show abstract] [Hide abstract]
ABSTRACT: This paper presents a robotic system for 3D upperlimb robot-aided rehabilitation, grounded on a patient-tailored approach: it real-time adapts therapy characteristics to patient needs, by including the patient in the control loop. The system is composed of a 7-DoF robot arm, an adaptive interaction control system and a module for the evaluation of patient performance; it records patient biomechanical data through an unobtrusive sensory system, evaluates patient biomechanical state and updates robot control parameters for modifying the level of assistance and task complexity in the 3D space. The adaptive interaction control and the module for assessing patient biomechanical state are described in detail in the paper. The experimental validation is carried out on healthy subjects and results in 2D and 3D space are provided.Robotics and Automation (ICRA), 2013 IEEE International Conference on; 01/2013