Effects of Upper Limb Robot-Assisted Rehabilitation Compared with Conventional Therapy in Patients with Stroke: Preliminary Results on a Daily Task Assessed Using Motion Analysis

Abstract

Robotic rehabilitation of the upper limb has demonstrated promising results in terms of the improvement of arm function in post-stroke patients. The current literature suggests that robot-assisted therapy (RAT) is comparable to traditional approaches when clinical scales are used as outcome measures. Instead, the effects of RAT on the capacity to execute a daily life task with the affected upper limb are unknown, as measured using kinematic indices. Through kinematic analysis of a drinking task, we examined the improvement in upper limb performance between patients following a robotic or conventional 30-session rehabilitation intervention. In particular, we analyzed data from nineteen patients with subacute stroke (less than six months following stroke), nine of whom treated with a set of four robotic and sensor-based devices and ten with a traditional approach. According to our findings, the patients increased their movement efficiency and smoothness regardless of the rehabilitative approach. After the treatment (either robotic or conventional), no differences were found in terms of movement accuracy, planning, speed, or spatial posture. This research seems to demonstrate that the two investigated approaches have a comparable impact and may give insight into the design of rehabilitation therapy.

Simulation of a control method for active kinesiotherapy with an upper extremity rehabilitation exoskeleton without force sensor

“…While detecting such, the drives corresponding to the motion have to react and act based on the identified motion intention. However, the described differences can also result from the unintended activity of an impaired user with coordination problems [ 32 ], model inaccuracies or other noises in the control system. The investigation aims to analyse the impact of the method’s parameters and assess its vulnerability to the presented disruptions.…”

Simulation of a control method for active kinesiotherapy with an upper extremity rehabilitation exoskeleton without force sensor

“…While detecting such, the drives corresponding to the motion have to react and act based on the identified motion intention. However, the described differences can also result from the unintended activity of an impaired user with coordination problems [23], model inaccuracies or other noises in the control system.…”

Validity of movement smoothness metrics for upper limb reaching movements in people with moderate to severe subacute stroke

“…Spastic paresis directly alters the movement trajectories and velocity with spatial (poor movement control, less e cient trajectories) and temporal (longer movement duration) discontinuities, resulting in a lack of smoothness (17)(18)(19). Changes in the smoothness of the hand trajectory after stroke have been studied during reaching, grasping, and pointing movements (20), and the evaluation of smoothness has been suggested as a valid indicator of the quality of spontaneous motor recovery (21)(22)(23)(24) and rehabilitation-induced recovery (19,(25)(26)(27).…”