Quantitative Evaluation of Performance during Robot-assisted Treatment

2016 ◽  
Vol 55 (01) ◽  
pp. 84-88 ◽  
Author(s):  
E. Biffi ◽  
C. Maghini ◽  
F. Servodio Iammarrone ◽  
C. Gagliardi ◽  
C. Germiniasi ◽  
...  

SummaryIntroduction: This article is part of the Focus Theme of Methods of Information in Medicine on “Methodologies, Models and Algorithms for Patients Rehabilitation”. Objectives: The great potential of robots in extracting quantitative and meaningful data is not always exploited in clinical practice. The aim of the present work is to describe a simple parameter to assess the performance of subjects during upper limb robotic training exploiting data automatically recorded by the robot, with no additional effort for patients and clinicians. Methods: Fourteen children affected by cerebral palsy (CP) performed a training with Armeo®Spring. Each session was evaluated with P, a simple parameter that depends on the overall performance recorded, and median and interquartile values were computed to perform a group analysis. Results: Median (interquartile) values of P significantly increased from 0.27 (0.21) at T0 to 0.55 (0.27) at T1 . This improvement was functionally validated by a significant increase of the Melbourne Assessment of Unilateral Upper Limb Function. Conclusions: The parameter described here was able to show variations in performance over time and enabled a quantitative evaluation of motion abilities in a way that is reliable with respect to a well-known clinical scale.

2020 ◽  
Vol 60 (4) ◽  
pp. 217-222
Author(s):  
Kazuya SAITA ◽  
Takashi MORISHITA ◽  
Koichi HYAKUTAKE ◽  
Toshiyasu OGATA ◽  
Hiroyuki FUKUDA ◽  
...  

2018 ◽  
Vol 2018 ◽  
pp. 1-15 ◽  
Author(s):  
Marialuisa Gandolfi ◽  
Emanuela Formaggio ◽  
Christian Geroin ◽  
Silvia Francesca Storti ◽  
Ilaria Boscolo Galazzo ◽  
...  

Background. Bilateral arm training (BAT) has shown promise in expediting progress toward upper limb recovery in chronic stroke patients, but its neural correlates are poorly understood.Objective. To evaluate changes in upper limb function and EEG power after a robot-assisted BAT in chronic stroke patients.Methods. In a within-subject design, seven right-handed chronic stroke patients with upper limb paresis received 21 sessions (3 days/week) of the robot-assisted BAT. The outcomes were changes in score on the upper limb section of the Fugl-Meyer assessment (FM), Motricity Index (MI), and Modified Ashworth Scale (MAS) evaluated at the baseline (T0), posttraining (T1), and 1-month follow-up (T2). Event-related desynchronization/synchronization were calculated in the upper alpha and the beta frequency ranges.Results. Significant improvement in all outcomes was measured over the course of the study. Changes in FM were significant at T2, and in MAS at T1and T2. After training, desynchronization on the ipsilesional sensorimotor areas increased during passive and active movement, as compared with T0.Conclusions. A repetitive robotic-assisted BAT program may improve upper limb motor function and reduce spasticity in the chronically impaired paretic arm. Effects on spasticity were associated with EEG changes over the ipsilesional sensorimotor network.


2020 ◽  
pp. 1-5
Author(s):  
Divya S ◽  
◽  
Arunachalam Ramachandran ◽  
Janani R ◽  
◽  
...  

Knowledge of rehabilitation of stroke seeks to be important source of promoting recovery and independence of activity of daily living in stroke survivor. This study has the purpose to utilize the motor relearning program by means of task oriented approach. It is a novel approach towards the cortical reorganization in the sensorimotor cortex, where the sensation of normal movement pattern is achieved through variety of task practice. The major relearning of functional activity can be enhanced by increasing the intensity of task oriented practice. Subjects with cerebro vascular accident referred by their primary care physician to a physical therapist were recruited from the inpatient and outpatient department of Saveetha Medical Hospital based on the inclusion and exclusion criteria and informed consent obtained and was screened for the eligibility. The collected data was tabulated and analyzed using descriptive and inferential statistics. The results of pre-test and post-test within group analysis showed extremely statistically significant with p-test values (P=0.0001 and P <0.0001). It is concluded from this study that both the variety of tasks and number of repetition improves upper limb function following hemiplegia. Further intervention with more number of repetition resulted in a better recovery than intervention with more number of tasks.


2021 ◽  
Vol 39 (6) ◽  
pp. 435-446
Author(s):  
Cristina Fonte ◽  
Valentina Varalta ◽  
Arianna Rocco ◽  
Daniele Munari ◽  
Mirko Filippetti ◽  
...  

Background: Upper limb motor deficits in patients with severe stroke often remain unresolved over time. Combining transcranial Direct Current Stimulation with robotic therapy is an innovative neurorehabilitation approach that holds promise to improve upper limb impairment after stroke. Objective: To investigate the effects of robotic training in combination with transcranial Direct Current Stimulation for treating poststroke upper limb impairment. Methods: PubMed, MEDLINE, Cochrane Library, and EMBASE electronic databases were searched using keywords, MeSH terms, and strings: “Stroke”[MeSH] AND (“Upper Extremity”[MeSH] OR “upper limb”) AND (“Transcranial Direct Current Stimulation” [MeSH] OR “tDCS”) AND (“robotics” OR “robotic therapy”). Full-text articles published in English up to October 2020 were included. Each was rated for quality according to the Physiotherapy Database (PEDro) score: eight out of eleven scored more than 8 points; their results were considered reliable for this review. Results: Of the total of 171 publications retrieved, 11 met the inclusion criteria. The results of studies that examined the same outcome measures were pooled to draw conclusions on the effectiveness of transcranial Direct Current Stimulation and robot-assisted training in corticomotor excitability, upper limb kinematics, muscle strength and tone, function, disability, and quality of life after stroke. Conclusions: To date, there is insufficient evidence to support the hypothesis that transcranial Direct Current Stimulation enhances the effects of robot-assisted arm training in poststroke patients. Further studies with more accurate, comparable and standardized methodology are needed in order to better define the effects of robotic training in combination with transcranial Direct Current Stimulation on poststroke upper limb impairment. Therefore, given the scarce resources available to rehabilitation researches, other, more promising approaches should be given attention.


2019 ◽  
Vol 9 (24) ◽  
pp. 5357 ◽  
Author(s):  
Irene Aprile ◽  
Cristiano Pecchioli ◽  
Simona Loreti ◽  
Arianna Cruciani ◽  
Luca Padua ◽  
...  

Robotic rehabilitation is a promising way to restore upper limb function, but new organizational models are crucial in order to improve its sustainability. We aimed to analyze the feasibility of a robot-Assisted REhabilitation Area (robotAREA) equipped with four devices, using a new organizational model in which one physiotherapist supervises up to four patients. In 33 days, 60 patients were treated in the robotAREA. Two hundred fifty-five rehabilitation sessions were analyzed, each including two, three, or four patients supervised by one physiotherapist (the R2, R3, and R4 group, respectively). For each session, the duration of (a) setup, (b) training, (c) supervision, (d) session closure, and participant satisfaction were measured. For each patient, upper limb impairment, disability, mobility, and comorbidity were recorded. The time of training in the R4 group was lower by only 2 and 3 min compared to the R2 and R3 groups, respectively, while the supervision significantly changed between the R2, R3, and R4 groups. No differences were observed in satisfaction. Moreover, according to the logistic regression analysis, when the mean disability of the group is moderate, four patients can be supervised by one physiotherapist. These results suggest that the proposed model is feasible, and the mean disability of the group could influence the proper physiotherapist/patient ratio.


2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Qingming Qu ◽  
Yingnan Lin ◽  
Zhijie He ◽  
Jianghong Fu ◽  
Fei Zou ◽  
...  

Stroke is one of the leading causes of death and the primary cause of acquired disability worldwide. Many stroke survivors have difficulty using their upper limbs, which have important functional roles in the performance of daily life activities. Consequently, the independence and quality of life of most stroke patients are reduced. Robot-assisted therapy is an effective intervention for improving the upper limb function of individuals with stroke. Human-robot collaborative interaction force control technology is critical for improving the flexibility and followability of the robot’s motion, thereby improving rehabilitation training outcomes. However, there are few reports on the effect of robot-assisted rehabilitative training on upper limb function. We applied this technology using a robot to assist patients with task-oriented training. Posttreatment changes in Fugl-Meyer and modified Barthel index (MBI) scores were assessed to determine whether this technology could improve the upper limb function of stroke patients. One healthy adult and five stroke patients, respectively, participated in functional and clinical experiments. The MBI and Fugl-Meyer scores of the five patients in the clinical experiments showed significant improvements after the intervention. The experimental results indicate that human-robot collaborative interaction force control technology is valuable for improving robots’ properties and patients’ recovery. This trial was registered in the Chinese clinical trial registry (ChiCTR2000038676).


Author(s):  
DAESEOK YOON ◽  
SEUNGBOK LEE ◽  
SANG-HYUN CHO ◽  
HAEYEAN PARK ◽  
JONGBAE KIM

The objective of this research study was to investigate the effect of patient-centered robot-assisted intervention for upper limb function improvement in stroke patients. Design: A double-blind randomized controlled trial. Intervention: Subjectively preferred areas of need for performing daily activities were identified by pre-interviewing and applied as target goals in the experimental group using a robotic device. Control-1 underwent a program focused on the robot system involving movements of upper limb joints. Control-2 participated in a conventional rehabilitation program. Methods: Forty-five participants engaged in 60 min of daily therapy, five times weekly for 3 weeks. The experimental group used the Canadian occupational performance measure (COPM) to identify subjectively preferred “patient-centered” focus needed areas to perform robotic device aided daily activities. Control-1 used a robot device-focused rehabilitation involving upper limb joint movements. Control-2 participated in conventional rehabilitation. Pre-post intervention measurements of hand, grip, power, and upper limb ROM were acquired by FMA-UE, MFT, and K-MBI. Results: A significant increase of function in the experimental group was observed in each subclass of function and activities of daily living (ADL) performance. Control-1 showed an increase in function without ADL improvement. Control-2 showed an increase in ADL and proximal areas of upper limb function without an increase in other areas. Conclusion: The “patient-centered” approach significantly improved upper limb function and ADL performance compared to “robot-centered” rehabilitation. Further studies are warranted to confirm these results and for generalizability in clinical application.


2013 ◽  
Vol 25 (4) ◽  
pp. 407-409 ◽  
Author(s):  
Doo Han Yoo ◽  
Yong Jun Cha ◽  
Su kyoung Kim ◽  
Jae Shin Lee

2014 ◽  
Vol 37 (1) ◽  
pp. 67-73 ◽  
Author(s):  
Patrizio Sale ◽  
Federica Bovolenta ◽  
Maurizio Agosti ◽  
Pierina Clerici ◽  
Marco Franceschini

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