Use of a robotic device for the rehabilitation of severe upper limb paresis in subacute stroke: exploration of patient/robot interactions and the motor recovery process

Biomed Res Int. 2015:2015:482389. doi: 10.1155/2015/482389. Epub 2015 Mar 2.

Abstract

This pioneering observational study explored the interaction between subacute stroke inpatients and a rehabilitation robot during upper limb training. 25 stroke survivors (age 55 ± 17 years; time since stroke, 52 ± 21 days) with severe upper limb paresis carried out 16 sessions of robot-assisted shoulder/elbow training (InMotion 2.0, IMT, Inc., MA, USA) combined with standard therapy. The values of 3 patient/robot interaction parameters (a guidance parameter: Stiffness, a velocity-related parameter: Slottime, and Robotic Power) were compared between sessions 1 (S1), 4 (S4), 8 (S8), 12 (S12), and 16 (S16). Pre/post Fugl-Meyer Assessment (FMA) scores were compared in 18 patients. Correlations between interaction parameters and clinical and kinematic outcome measures were evaluated. Slottime decreased at S8 (P = 0.003), while Guidance decreased at S12 (P = 0.008). Robotic Power tended to decrease until S16. FMA scores improved from S1 to S16 (+49%, P = 0.002). Changes in FMA score were correlated with the Stiffness parameter (R = 0.4, P = 0.003). Slottime was correlated with movement velocity. This novel approach demonstrated that a robotic device is a useful and reliable tool for the quantification of interaction parameters. Moreover, changes in these parameters were correlated with clinical and kinematic changes. These results suggested that robot-based recordings can provide new insights into the motor recovery process.

Publication types

  • Observational Study

MeSH terms

  • Arm / physiopathology
  • Equipment Design
  • Equipment Failure Analysis
  • Female
  • Humans
  • Male
  • Man-Machine Systems
  • Middle Aged
  • Paresis / diagnosis
  • Paresis / physiopathology*
  • Paresis / rehabilitation*
  • Recovery of Function / physiology*
  • Robotics / instrumentation*
  • Stroke / diagnosis
  • Stroke / physiopathology*
  • Stroke Rehabilitation*
  • Therapy, Computer-Assisted / instrumentation
  • Treatment Outcome