Quantitative Evaluation of Performance during Robot-assisted Treatment

Abstract

SummaryIntroduction: This article is part of the Focus Theme of Methods of Information in Medicine on "Methodologies, Models and Algorithms for Patients Rehabilitation". Objectives: The great potential of robots in extracting quantitative and meaningful data is not always exploited in clinical practice. The aim of the present work is to describe a simple parameter to assess the performance of subjects during upper limb robotic training exploiting data automatically recorded by the robot, with no additional effort for patients and clinicians.Methods: Fourteen children affected by cerebral palsy (CP) performed a training with Armeo ® Spring. Each session was evaluated with P, a simple parameter that depends on the overall performance recorded, and median and interquartile values were computed to perform a group analysis. Results: Median (interquartile) values of P significantly increased from 0.27 (0.21) at T 0 to 0.55 (0.27) at T 1 . This improvement was functionally validated by a significant increase of the Melbourne Assessment of Unilateral Upper Limb Function. Conclusions: The parameter described here was able to show variations in performance over time and enabled a quantitative evaluation of motion abilities in a way that is reliable with respect to a well-known clinical scale.

Movement Velocity and Fluidity Improve after Armeo®Spring Rehabilitation in Children Affected by Acquired and Congenital Brain Diseases: An Observational Study

“…The present study investigates the effectiveness of Armeo®Spring-based rehabilitation, coupled to physiotherapy, on a population which few other studies on the same topic have analyzed. Few manuscripts have already reported functional improvements in CP children after robot-aided rehabilitation with Armeo®Spring; the improvement reported here in terms of Melbourne scale was as significant as in [15, 16], even though the patients had lower scores at baseline and the variation between baseline and final evaluation was smaller as well. In contrast, they showed a significant improvement in the QUEST scale that was not reported in [16].…”

“…Upper limb robot-aided therapy has shown good functional improvements in terms of coordination and fluency in the pediatric population, using both end-effector robots [8, 10–14] and passive exoskeletons [15, 16].…”

“…Moreover, it has higher resolution as well as better interrater and intrarater reliability with respect to clinical scales. It has been shown that robot-based measurements can be correlated with clinical scales assessing adults' [17, 19–21] and children's [15, 22] abilities: these data can support clinicians in the assessment of a patient's progress and capabilities. Recently, Merlo and coworkers developed a tool to exploit the built-in technology of the exoskeleton Armeo®Spring to extract indexes of accuracy, velocity, and smoothness in the evaluation of upper limb function and obtained normative data in healthy adults [23].…”

Rehabilitation of Upper Limb in Children with Acquired Brain Injury: A Preliminary Comparative Study

“…Another critical point concerns the group of patients who received robotic treatment with Armeo. They had overall worse limb function when beginning treatment than the other patients and even than other groups performing this treatment [ 10 , 11 ], and this could have determined the lack of improvement in kinematic data.…”

“…When combined with interactive programs such as virtual reality, robot-aided therapy can assign functional meaning to the therapy, creating a motivating environment [ 6 – 9 ]. Studies involving robotic therapy have shown improvements in upper limb coordination and fluency of movement in the hands and fingers of children with cerebral palsy [ 10 , 11 ].…”