Tele-Rehabilitation Versus Local Rehabilitation Therapies Assisted by Robotic Devices: A Pilot Study with Patients

Abstract

The present study aims to evaluate the advantages of a master-slave robotic rehabilitation therapy in which the patient is assisted in real-time by a therapist. We have also explored if this type of strategy is applicable in a tele-rehabilitation environment. A pilot study has been carried out involving 10 patients who have performed a point-to-point rehabilitation exercise supported by three assistance modalities: fixed assistance (without therapist interaction), local therapist assistance, and remote therapist assistance in a simulated tele-rehabiliation scenario. The rehabilitation exercise will be performed using an upper-limb rehabilitation robotic device that assists the patients through force fields. The results suggest that the assistance provided by the therapist is better adapted to patient needs than fixed assistance mode. Therefore, it maximizes the patient’s level of effort, which is an important aspect to improve the rehabilitation outcomes. We have also seen that in a tele-rehabilitation environment it is more difficult to assess when to assist the patient than locally. However, the assistance suits patients better than the fixed assistance mode.

Patients’ physiological reactions to competitive rehabilitation therapies assisted by robotic devices

“…This method assists only when the patients cannot move toward the target at a velocity greater than the minimum velocity required, allowing them to move freely toward the target in case no assistance is needed. This force-field-based assistance mode has already been validated in other studies with patients [19,45].…”

“…Two Rubidium devices were used in this study [ 19 , 42 , 43 ]. Rubidium is commercialized and distributed by the spin-off iDRhA [ 44 ].…”

“…However, an under-utilized resource in stroke rehabilitation assisted by robotic devices is social interaction as a factor that increases patients' motivation and, therefore, the intensity of therapy. Social interaction in the form of multiplayer games has been highlighted as a potential element to increase patient motivation in motor rehabilitation therapies, both a therapist playing with a patient [19][20][21], and two patients [22][23][24][25][26]. Most studies evaluating multiplayer therapies present preliminary results in the current state of the art.…”