Background and purposeThere is little evidence available on the use of robot-assisted therapy in subacute stroke patients. A randomized controlled trial was carried out to evaluate the short-time efficacy of intensive robot-assisted therapy compared to usual physical therapy performed in the early phase after stroke onset.MethodsFifty-three subacute stroke patients at their first-ever stroke were enrolled 30 ± 7 days after the acute event and randomized into two groups, both exposed to standard therapy. Additional 30 sessions of robot-assisted therapy were provided to the Experimental Group. Additional 30 sessions of usual therapy were provided to the Control Group.The following impairment evaluations were performed at the beginning (T0), after 15 sessions (T1), and at the end of the treatment (T2): Fugl-Meyer Assessment Scale (FM), Modified Ashworth Scale-Shoulder (MAS-S), Modified Ashworth Scale-Elbow (MAS-E), Total Passive Range of Motion-Shoulder/Elbow (pROM), and Motricity Index (MI).ResultsEvidence of significant improvements in MAS-S (p = 0.004), MAS-E (p = 0.018) and pROM (p < 0.0001) was found in the Experimental Group. Significant improvement was demonstrated in both Experimental and Control Group in FM (EG: p < 0.0001, CG: p < 0.0001) and MI (EG: p < 0.0001, CG: p < 0.0001), with an higher improvement in the Experimental Group.ConclusionsRobot-assisted upper limb rehabilitation treatment can contribute to increasing motor recovery in subacute stroke patients. Focusing on the early phase of stroke recovery has a high potential impact in clinical practice.

PD participants maintain their Faith in spite of the disease severity. Differences are found between right and left onset of PD. The possible beneficial effect of religious coping is discussed.

The post-stroke aftermath of patients suffering from atrial fibrillation (AF) is investigated. A total of 104 consecutive patients (80 with AF and 24 without AF) were referred to a rehabilitation centre and enrolled. They underwent a rehabilitative programme. Disability was assessed by using the Functional Independence Measure (FIM), at the time of admission, discharge and after 1 year. Death was more frequent over the 1-year interval in AF group. Ten patients died (42%), whereas in the non-AF group death occurred in 15 cases (19%). By using chi-square test, the difference was significant (P < 0.02). The logistic regression analysis indicated that the unique variable affecting the FIM at follow-up was the FIM at discharge (P < 0.0001). AF was not a significant variable in the equation. The result can be attributed to subject attrition in the AF group, as the most severe patients died and survivors could benefit from a better functional status.

This article reflects the conviction that clinicians with a special knowledge on LBP problems and researchers with a special knowledge on health policy will better work together. Their targets are outcome and cost-benefit ratio by taking into account the economical and political milieu of the country where the research is carried out.

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