Upper limb robot-assisted therapy in subacute and chronic stroke patients using an innovative end-effector haptic device: A pilot study

Article type: Research Article

Authors: Mazzoleni, S.^{a; b; *} | Battini, E.^{a; b} | Crecchi, R.^b | Dario, P.^a | Posteraro, F.^{b; c}

Affiliations: [a] The BioRobotics Institute, Scuola Superiore Sant’Anna, Polo Sant’Anna Valdera, Pontedera (Pisa), Italy | [b] Rehabilitation Bioengineering Laboratory, Auxilium Vitae Rehabilitation Center, Volterra, Italy | [c] Rehabilitation Department, Versilia Hospital, Azienda USL Toscana Nord Ovest, Italy

Correspondence: [*] Address for correspondence: Stefano Mazzoleni, PhD, The BioRobotics Institute, Scuola Superiore Sant’Anna, Polo Sant’Anna Valdera, V.le R. Piaggio 34, 56025 Pontedera, Italy. Tel.: +39 050883132; Fax: +39 050883101; E-mail: stefano.mazzoleni@santannapisa.it.

Abstract: BACKGROUND:Significant results have been shown when an upper limb robot-assisted rehabilitation is delivered to stroke patients. OBJECTIVE:To evaluate the effects of upper limb robot-assisted rehabilitation on motor recovery in stroke patients who underwent a treatment based on a haptic device. METHODS:Thirty-nine stroke patients (twenty-three subacute and sixteen chronic) underwent rehabilitation training by using MOTORE/Armotion haptic system. Thirteen healthy subjects were recruited for comparison purpose.The following clinical outcome measures were used: Chedoke-McMaster Stroke Assessment, Modified Ashworth Scale (MAS), Fugl-Meyer Assessment (FM), Medical Research Council, Motricity Index (MI), Box and Block Test (B&B) and Modified Barthel Index (mBI).The following parameters were computed: mean speed, maximum speed, mean time, path length, normalized jerk, mean force, mean error, mean energy expenditure and active patient-robot interaction percentage.The assessments were carried-out before and after treatment. RESULTS:Significant changes were observed in both groups in the FM, MI, B&B and mean speed. Significant changes were observed in mBI, mean time, mean force, mean energy expenditure and active patient-robot interaction percentage in subacute stroke patients. In chronic stroke patients significant changes were found on the MAS-elbow. CONCLUSIONS:The haptic device used is at least as effective as an existing device used in similar studies.

Keywords: Stroke, rehabilitation, upper limb, haptics, robotics

DOI: 10.3233/NRE-172166

Journal: NeuroRehabilitation, vol. 42, no. 1, pp. 43-52, 2018