Robot-assisted Rehabilitation Using Multiple Types of Hybrid Assistive Limb for Acute Stroke Patients

Abstract Purpose Robot-assisted gait rehabilitation has been proposed as a plausible supplementary rehabilitation strategy in stroke rehabilitation in the last decade. However, its exact benefit over traditional rehabilitation remain sparse and unclear. It is therefore the purpose of the current study to comparatively investigate the clinical benefits of the additional robot-assisted training in acute stroke patients compared to standard hospital rehabilitation alone. Methods Ninety acute stroke patients (< 3 month) were recruited. All participants received the standard hospital neurorehabilitation comprises 45–60 min sessions daily for 3 weeks. Sixty patients also received an additional 30 min of robot-assisted gait training with the HIWIN MRG-P100 gait training system after each of the standard neurorehabilitation session. Outcome measures included: 1. Berg Balance Scale (BBS); 2. Brunnstrom Stage; 3. Pittsburgh Sleep Quality Index and 4. Taiwanese Depression Questionnaire (TDQ) which were assessed pre-treatment and then after every five training sessions. Results Both groups demonstrated significant improvement pre- and post-treatment for the BBS (robotic group p = 0.023; control group p = 0.033) but no significant difference (p > 0.1) between the groups were found. However, the robotic training group had more participants demonstrating larger BBS points of improvement as well as greater Brunnstrom stage of improvement, when compared to the control group. No significant within and between group statistical differences (p > 0.3) were found for Pittsburgh Sleep Quality Index and Taiwanese Depression Questionnaire. Conclusion The addition of robotic gait training on top of standard hospital neurorehabilitation for acute stroke patients appear to produce a slightly greater improvement in clinical functional outcomes, which is not transferred to psychological status.

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Tailor-made rehabilitation approach using multiple types of hybrid assistive limb robots for acute stroke patients: A pilot study

Assistive Technology ◽

10.1080/10400435.2015.1080768 ◽

2015 ◽

Vol 28 (1) ◽

pp. 53-56 ◽

Cited By ~ 22

Author(s):

Hiroyuki Fukuda ◽

Takashi Morishita ◽

Toshiyasu Ogata ◽

Kazuya Saita ◽

Koichi Hyakutake ◽

...

Keyword(s):

Pilot Study ◽

Acute Stroke ◽

Stroke Patients ◽

Hybrid Assistive Limb

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Hand Robotics Rehabilitation: Feasibility and Preliminary Results of a Robotic Treatment in Patients with Hemiparesis

Stroke Research and Treatment ◽

10.1155/2012/820931 ◽

2012 ◽

Vol 2012 ◽

pp. 1-5 ◽

Cited By ~ 38

Author(s):

Patrizio Sale ◽

Valentina Lombardi ◽

Marco Franceschini

Keyword(s):

Acute Stroke ◽

Hand Function ◽

Stroke Patients ◽

Robot Assisted ◽

Rehabilitative Treatment ◽

Modified Ashworth Scale ◽

Extensor Muscles ◽

Function Recovery ◽

Ashworth Scale ◽

Flexion And Extension

Background. No strongly clinical evidence about the use of hand robot-assisted therapy in stroke patients was demonstrated. This preliminary observer study was aimed at evaluating the efficacy of intensive robot-assisted therapy in hand function recovery, in the early phase after a stroke onset.Methods. Seven acute ischemic stroke patients at their first-ever stroke were enrolled. Treatment was performed using Amadeo robotic system (Tyromotion GmbH Graz, Austria). Each participant received, in addition to inpatients standard rehabilitative treatment, 20 sessions of robotic treatment for 4 consecutive weeks (5 days/week). Each session lasted for 40 minutes. The exercises were carried out as follows: passive modality (5 minutes), passive/plus modality (5 minutes), assisted therapy (10 minutes), and balloon (10 minutes). The following impairment and functional evaluations, Fugl-Meyer Scale (FM), Medical Research Council Scale for Muscle Strength (hand flexor and extensor muscles) (MRC), Motricity Index (MI), and modified Ashworth Scale for wrist and hand muscles (AS), were performed at the beginning (T0), after 10 sessions (T1), and at the end of the treatment (T2). The strength hand flexion and extension performed by Robot were assessed at T0 and T2. The Barthel Index and COMP (performance and satisfaction subscale) were assessed at T0 and T2.Results. Clinical improvements were found in all patients. No dropouts were recorded during the treatment and all subjects fulfilled the protocol. Evidence of a significant improvement was demonstrated by the Friedman test for the MRC (P<0.0123). Evidence of an improvement was demonstrated for AS, FM, and MI.Conclusions. This original rehabilitation treatment could contribute to increase the hand motor recovery in acute stroke patients. The simplicity of the treatment, the lack of side effects, and the first positive results in acute stroke patients support the recommendations to extend the clinical trial of this treatment, in association with physiotherapy and/or occupational therapy.

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Efficacy of end-effector robot-assisted gait training combined with robotic balance training in sub-acute stroke patients: preliminary results

Gait & Posture ◽

10.1016/j.gaitpost.2019.07.475 ◽

2019 ◽

Vol 74 ◽

pp. 22-23

Author(s):

C. Iacovelli ◽

L. Castelli ◽

C. Pecchioli ◽

I. Aprile

Keyword(s):

Acute Stroke ◽

Balance Training ◽

Gait Training ◽

Stroke Patients ◽

Robot Assisted ◽

End Effector ◽

Preliminary Results

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Recovery of hand function with robot-assisted therapy in acute stroke patients

International Journal of Rehabilitation Research ◽

10.1097/mrr.0000000000000059 ◽

2014 ◽

Vol 37 (3) ◽

pp. 236-242 ◽

Cited By ~ 46

Author(s):

Patrizio Sale ◽

Stefano Mazzoleni ◽

Valentina Lombardi ◽

Daniele Galafate ◽

Maria P. Massimiani ◽

...

Keyword(s):

Acute Stroke ◽

Hand Function ◽

Stroke Patients ◽

Robot Assisted

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Upper-limb robot-assisted therapy in rehabilitation of acute stroke patients: Focused review and results of new randomized controlled trial

The Journal of Rehabilitation Research and Development ◽

10.1682/jrrd.2010.04.0063 ◽

2011 ◽

Vol 48 (4) ◽

pp. 355 ◽

Cited By ~ 108

Author(s):

Stefano Masiero ◽

Mario Armani ◽

Giulio Rosati

Keyword(s):

Randomized Controlled Trial ◽

Acute Stroke ◽

Upper Limb ◽

Controlled Trial ◽

Stroke Patients ◽

Robot Assisted ◽

Randomized Controlled

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EFFICACY OF END-EFFECTOR ROBOT-ASSISTED GAIT TRAINING COMBINED WITH ROBOTIC BALANCE TRAINING IN SUB-ACUTE STROKE PATIENTS: PRELIMINARY RESULTS

Gait & Posture ◽

10.1016/j.gaitpost.2019.07.415 ◽

2019 ◽

Keyword(s):

Acute Stroke ◽

Balance Training ◽

Gait Training ◽

Stroke Patients ◽

Robot Assisted ◽

End Effector ◽

Preliminary Results

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Effects of short-term upper limb robot-assisted therapy on the rehabilitation of sub-acute stroke patients

Technology and Health Care ◽

10.3233/thc-202127 ◽

2020 ◽

pp. 1-9

Author(s):

Shangrong Jiang ◽

Hong You ◽

Weijing Zhao ◽

Min Zhang

Keyword(s):

Activities Of Daily Living ◽

Acute Stroke ◽

Motor Function ◽

Upper Limb ◽

Daily Living ◽

Muscle Tone ◽

Stroke Patients ◽

Robot Assisted ◽

Short Term ◽

Significant Difference

BACKGROUND: Robot-assisted therapy (RT) has become a promising stroke rehabilitation intervention. OBJECTIVE: To examine the effects of short-term upper limb RT on the rehabilitation of sub-acute stroke patients. METHODS: Subjects were randomly assigned to the RT group (n= 23) or conventional rehabilitation (CR) group (n= 22). All subjects received conventional rehabilitation therapy for 30 minutes twice a day, for 2 weeks. In addition, the RT group received RT for 30 minutes twice a day, for 2 weeks. The outcomes before treatment (T0) and at 2 weeks (T1) and 1 month follow-up (T2) were evaluated in the patients using the upper limb motor function test of the Fugl-Meyer assessment (FMA) the Motricity Index (MI), the Modified Ashworth Scale (MAS), the Functional Independence Measure (FIM), and the Barthel Index (BI). RESULTS: There were significant improvements in motor function scales (P< 0.001 for FMA and MI) and activities of daily living (P< 0.001 for FIM and BI) but without muscle tone (MAS, P> 0.05) in the RT and CR groups. Compared to the CR group, the RT group showed improvements in motor function and activities of daily living (P< 0.05 for FMA, MI, FIM, BI) at T1 and T2. There was no significant difference between the two groups in muscle tone (MAS, P> 0.05). CONCLUSIONS: RT may be a useful tool for sub-acute stroke patients’ rehabilitation.

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