Does assist-as-needed upper limb robotic therapy promote participation in repetitive activity-based motor training in sub-acute stroke patients with severe paresis?

Issue title: Special Section: Journey of a Pioneer: Dr Stefan Hesse 1960-2016. Robotics, Reflections and What’s Next

Guest editors: Hermano Igo Krebs

Article type: Research Article

Authors: Grosmaire, Anne-Gaëlle^a | Duret, Christophe^{a; b; *}

Affiliations: [a] Centre de Rééducation Fonctionnelle Les Trois Soleils, Médecine Physique et de Réadaptation, Unité de Neurorééducation, Boissise-Le-Roi, France | [b] Centre Hospitalier Sud Francilien, Neurologie, Corbeil-Essonnes, France

Correspondence: [*] Address for correspondence: Christophe Duret, MD, CRF Les Trois Soleils Neurorehabilitation Unit, 19 rue du Château, 77310 Boissise-Le-Roi, France. Tel.: +33164718082; Fax: +33160657625; E-mail: ch.duret@les-trois-soleils.fr.

Abstract: BACKGROUND: Repetitive, active movement-based training promotes brain plasticity and motor recovery after stroke. Robotic therapy provides highly repetitive therapy that reduces motor impairment. However, the effect of assist-as-needed algorithms on patient participation and movement quality is not known. OBJECTIVE: To analyze patient participation and motor performance during highly repetitive assist-as-needed upper limb robotic therapy in a retrospective study. METHODS: Sixteen patients with sub-acute stroke carried out a 16-session upper limb robotic training program combined with usual care. The Fugl-Meyer Assessment (FMA) score was evaluated pre and post training. Robotic assistance parameters and Performance measures were compared within and across sessions. RESULTS: Robotic assistance did not change within-session and decreased between sessions during the training program. Motor performance did not decrease within-session and improved between sessions. Velocity-related assistance parameters improved more quickly than accuracy-related parameters. CONCLUSIONS: An assist-as-needed-based upper limb robotic training provided intense and repetitive rehabilitation and promoted patient participation and motor performance, facilitating motor recovery.

Keywords: Hemiparesis, assist-as-needed, motor performance, participation, robotic therapy

DOI: 10.3233/NRE-171454

Journal: NeuroRehabilitation, vol. 41, no. 1, pp. 31-39, 2017