Effects of Intensive Vibratory Treatment with a Robotic System on the Recovery of Sensation and Function in Patients with Subacute and Chronic Stroke: A Non-Randomized Clinical Trial

Abstract

Background: Sensory–motor deficits are frequent and affect the functionality after stroke. The use of robotic systems to improve functionality and motor performance is advisable; therefore, the aim of the present study was to evaluate the effects of intensive, high-frequency vibration treatment administered with a robotic system in subacute and chronic stroke patients in terms of upper limb sensitivity, motor function, quantity and quality of movement, and quality of life. Methods: A simple-blind, non-randomized controlled trial was conducted. The control group received conventional rehabilitation treatment and the experimental group received robotic treatment with an Amadeo® robot in addition to their conventional rehabilitation sessions. Results: Intragroup analysis identified significant improvements in the experimental group in hand (p = 0.012), arm (p = 0.018), and shoulder (p = 0.027) sensitivity, as well as in motor function (FMA-UEmotor function, p= 0.028), integration of the affected limb (MAL-14amount scale, p = 0.011; MAL-14How well scale, p = 0.008), and perceived quality of life (SIS-16, p = 0.008). The measures between the control and experimental groups showed statistically significant differences in motor performance and spontaneous use of the affected limb (MAL-14amount scale, p = 0.021; MAL-14How well scale, p = 0.037). Conclusion: Intensive, high-frequency vibration with a robotic system, in combination with conventional intervention, improves the recovery of upper limb function in terms of quantity and quality of movement in patients with subacute and chronic stroke.

Reliability and Validity of the Motor Activity Log (MAL-30) Scale for Post-Stroke Patients in a Spanish Sample

“…However, in the case of the MAL-30 scale, it corresponds to an instrument that is widely used in clinical practice; thus, it requires the support of the professionals who use it. Likewise, the translation of this instrument has been used in other studies [ 20 , 31 , 32 , 33 , 34 ]. This content validation process can therefore be considered as already completed for this assessment tool.…”

“…The MAL-30 measure has been validated in several countries [ 20 , 22 , 26 , 27 , 28 , 29 , 30 ] and has been translated into Spanish, but it was uniquely adapted to the Hispanic American population [ 20 , 31 ]. However, some studies that were carried out in Spain [ 32 , 33 , 34 ] used this version that was translated into Spanish but not validated for this population. Because of this, despite the fact that it is a scale that is currently being used in various studies, the MAL assessment instrument has not been validated for post-stroke patients in the Spanish population.…”

How Do Motor and Sensory Function Correlate with Daily Performance Recovery after Post-Stroke Robotic Intervention? A Secondary Analysis of a Non-Randomized Controlled Trial

“…Previous preliminary studies have explored the effectiveness of the Amadeo ® system for the recovery of motor functions after stroke [ 19 , 20 ]. Recently, a clinical trial conducted by our research group showed that the use of this system, in combination with conventional intervention, produces partial improvements in sensory and motor function in daily upper limb performance in terms of quantity and quality of movement, and in the overall performance of basic and instrumental activities of daily living [ 21 ]. However, it is still unknown whether baseline levels of sensory and motor function, as well as previous performance levels, are related to improvements in upper limb and daily activity performance following this intervention.…”

“…However, most research has explored the effectiveness in terms of gait function and performance [ 22 ], or in terms of upper limb motor function [ 23 , 24 ], and only few studies have focused on the effectiveness of robot systems in terms of both sensory and motor function and upper limb or overall performance [ 25 ]. While findings of our previous work suggest that a combination of conventional treatment and a robot system intervention may lead to partial improvements in sensorimotor function and both upper limb and overall daily performance [ 21 ], the relationship between baseline levels of function and performance and post-intervention improvements is still unclear. Exploring this relationship would contribute to a better prognosis and understanding of the specific variables predicting post-intervention outcomes following a stroke, and it would allow for a more tailored approach.…”

“…Therefore, the aim of this study is to perform a secondary analysis of the data from the clinical trial conducted by Rodriguez-Perez et al [ 21 ] to determine the relationship between baseline levels of sensory and motor function and daily motor performance and their impact on the post-intervention improvement of performance in people with subacute and chronic stroke.…”