Assessment of human wrist rigidity and pain in post-traumatic patients

Albanese, Giulia A.; Marini, Francesca; Taglione, Elisa; Gasparini, Cecilia; Grandi, Sara; Pettinelli, Foebe; Sardelli, Claudio; Catitti, Paolo; Sandini, Giulio; Masia, Lorenzo; Zenzeri, Jacopo

doi:10.1109/icorr.2019.8779508

Cited by 13 publications

(12 citation statements)

References 12 publications

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“…In order to improve motor recovery and maximize the effectiveness of rehabilitation protocols for these clinical populations, a deep investigation of proprioception is necessary to clarify how these sensory afferents are related and contribute to the motor outcome (Masia et al, 2009a;De Santis et al, 2015;Zabihhosseinian et al, 2015). Despite this, the influence of both neural mechanisms (Marini et al, 2019) and intrinsic wrist mechanical properties (Albanese et al, 2019;Falzarano et al, 2020) on proprioceptive processes has still been poorly investigated.…”

Section: Introductionmentioning

confidence: 99%

Wrist Position Sense in Two Dimensions: Between-Hand Symmetry and Anisotropic Accuracy Across the Space

Albanese

Holmes

Marini

et al. 2021

Front. Hum. Neurosci.

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A deep investigation of proprioceptive processes is necessary to understand the relationship between sensory afferent inputs and motor outcomes. In this work, we investigate whether and how perception of wrist position is influenced by the direction along which the movement occurs. Most previous studies have tested Joint Position Sense (JPS) through 1 degree of freedom (DoF) wrist movements, such as flexion/extension (FE) or radial/ulnar deviation (RUD). However, the wrist joint has 3-DoF and many activities of daily living produce combined movements, requiring at least 2-DoF wrist coordination. For this reason, in this study, target positions involved movement directions that combined wrist flexion or extension with radial or ulnar deviation. The chosen task was a robot-aided Joint Position Matching (JPM), in which blindfolded participants actively reproduced a previously passively assumed target joint configuration. The JPM performance of 20 healthy participants was quantified through measures of accuracy and precision, in terms of both perceived target direction and distance along each direction of movement. Twelve different directions of movement were selected and both hands tested. The left and right hand led to comparable results, both target extents and directions were differently perceived according to the target direction on the FE/RUD space. Moreover, during 2-DoF combined movements, subjects’ perception of directions was impaired when compared to 1-DoF target movements. In summary, our results showed that human perception of wrist position on the FE/RUD space is symmetric between hands but not isotropic among movement directions.

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Section: Introductionmentioning

confidence: 99%

Wrist Position Sense in Two Dimensions: Between-Hand Symmetry and Anisotropic Accuracy Across the Space

Albanese

Holmes

Marini

et al. 2021

Front. Hum. Neurosci.

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“…The structure of both the robot-based rehabilitative protocol and the traditional one was always chosen by the medical specialist, tailoring the treatment accordingly to the severity and the level of healing achieved by each subject. Robot-based exercises replaced traditional exercises preserving the corresponding goal, such as reducing rigidity [ 6 ] or improving stretch, muscle force or dexterity [ 7 , 10 , 42 ].…”

Section: Discussionmentioning

confidence: 99%

“…Wrist injuries could differ in terms of severity and site: lesions may involve flexor or extensor tendons, complexes made of fibrocartilage, ligaments, bones or more than one of these tissues [ 1 ]. Each tissue presents a different vascularization and consequently a different healing time [ 5 ], while the site of the lesion has a direct influence on the resulting functional impairment, such as the movement direction more compromised [ 6 ]. For these reasons and because of age differences, both orthopedic treatments and following rehabilitative approaches could differ between subjects [ 7 – 10 ].…”

Section: Introductionmentioning

confidence: 99%

“…Robot-assisted therapy meets the need of orthopedic patients for a personalized protocol and a maximized training effect, allowing levels of assistance or resistance tailored on the real-time performance. Actually, high-resolution recording of spatial and temporal data allows to compute novel performance indicators [ 6 , 22 , 23 ] and document constantly progresses related to therapy, assessed under repeatable and safe conditions. For these reasons, the use of a robotic system with post-traumatic subjects could decrease human therapists’ effort and increase the efficiency in terms of both treatment duration and final reached functionality.…”

Section: Introductionmentioning

confidence: 99%

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Efficacy of wrist robot-aided orthopedic rehabilitation: a randomized controlled trial

Albanese

Taglione

Gasparini

et al. 2021

J NeuroEngineering Rehabil

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Background In recent years, many studies focused on the use of robotic devices for both the assessment and the neuro-motor reeducation of upper limb in subjects after stroke, spinal cord injuries or affected by neurological disorders. Contrarily, it is still hard to find examples of robot-aided assessment and rehabilitation after traumatic injuries in the orthopedic field. However, those benefits related to the use of robotic devices are expected also in orthopedic functional reeducation. Methods After a wrist injury occurred at their workplace, wrist functionality of twenty-three subjects was evaluated through a robot-based assessment and clinical measures (Patient Rated Wrist Evaluation, Jebsen-Taylor and Jamar Test), before and after a 3-week long rehabilitative treatment. Subjects were randomized in two groups: while the control group (n = 13) underwent a traditional rehabilitative protocol, the experimental group (n = 10) was treated replacing traditional exercises with robot-aided ones. Results Functionality, assessed through the function subscale of PRWE scale, improved in both groups (experimental p = 0.016; control p < 0.001) and was comparable between groups, both pre (U = 45.5, p = 0.355) and post (U = 47, p = 0.597) treatment. Additionally, even though groups’ performance during the robotic assessment was comparable before the treatment (U = 36, p = 0.077), after rehabilitation the experimental group presented better results than the control one (U = 26, p = 0.015). Conclusions This work can be considered a starting point for introducing the use of robotic devices in the orthopedic field. The robot-aided rehabilitative treatment was effective and comparable to the traditional one. Preserving efficacy and safety conditions, a systematic use of these devices could lead to decrease human therapists’ effort, increase repeatability and accuracy of assessments, and promote subject’s engagement and voluntary participation. Trial Registration ClinicalTrial.gov ID: NCT04739644. Registered on February 4, 2021—Retrospectively registered, https://www.clinicaltrials.gov/ct2/show/study/NCT04739644.

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“…Вступ. За даними літературних джерел, 76-86% осіб працездатного віку отримують ушкодження дистальних відділів верхньої кінцівки різного ступеня важкості [1,2]. Приблизно 50% серед них становлять травми кісток передпліччя та зап'ястка; майже третина всіх переломів кісток скелету припадає на ушкодження структур, що формують променево-зап'ястковий суглоб [3,4].…”

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Effectiveness of the Influence of Physical Therapy on the Indicators of the Neurological and Functional Status of the Hand in People with Compression Neuropathy of the Median Nerve as a Postimmobilization Complication of Fractures of the Distal Forearm Bo

Byrchak¹

2021

Ukr. ž. med. bìol. sportu

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The social inconsistency of patients with hand injuries is due to the limitation of the possibilities of professional and labor activity (reduced qualifications, limited opportunities for training and retraining, inability to work in their specialty), which justifies the search for new methods of their rehabilitation. The purpose of the study was to determine the effectiveness of physical therapy on the indicators of the neurological and functional status of the hand in patients with compression neuropathy of the median nerve as a postimmobilization complication of fractures of the distal forearm bones. Material and methods. The study involved 56 people with postimmobilization contractures of the wrist joint, complicated by compression neuropathy of the median nerve, as a result of fracture of the bones of the distal forearm. They were divided into two groups: the control group (they practiced according to the principles of polyclinic rehabilitation with a predominance of passive means like manual techniques, preformed physical factors) and the main group (they were engaged in a developed physical therapy program based on the principles of International Classification of Functioning, Disability and Health with a predominance of active means like functional training; massage; warm wet compress combined with post-isometric muscle relaxation, posture treatment; kinesiological taping). The effectiveness of the program was assessed by the presence and degree of pain (VAS and DN4), goniometry results, signs of median nerve irritation (Phalen, Hoffmann-Tinel, Durkan), French Arm Test, ABILIHAND, DASH, Boston carpal tunnel questionnaire. Results and discussion. After the rehabilitation intervention, all examined patients showed a decrease in the intensity of pain at rest and during movement (according to VAS). Signs of compression neuropathy of the median nerve decreased (pain intensity according to the DN4 questionnaire, the prevalence of specific symptoms, the results of a quantitative assessment of the Boston carpal tunnel questionnaire). There was an improvement in the functioning of the upper limb according to the ABILIHAND, DASH, French Arm Test scales. For all the studied parameters, the patients of both groups showed a statistically significantly better result compared to the initial data (p <0.05). However, the patients of the main group showed a better result than the patients of the control group (p <0.05). Conclusion. The developed program of physical therapy with the predominant using of active rehabilitation means revealed a statistically significant better effect on the indicators of the neurological and functional status of the hand in persons with compression neuropathy of the median nerve as a postimmobilization complication of fractures of the distal forearm bones

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Assessment of human wrist rigidity and pain in post-traumatic patients

Cited by 13 publications

References 12 publications

Wrist Position Sense in Two Dimensions: Between-Hand Symmetry and Anisotropic Accuracy Across the Space

Wrist Position Sense in Two Dimensions: Between-Hand Symmetry and Anisotropic Accuracy Across the Space

Efficacy of wrist robot-aided orthopedic rehabilitation: a randomized controlled trial

Effectiveness of the Influence of Physical Therapy on the Indicators of the Neurological and Functional Status of the Hand in People with Compression Neuropathy of the Median Nerve as a Postimmobilization Complication of Fractures of the Distal Forearm Bo

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