Comparison of exercise training effect with different robotic devices for upper limb rehabilitation: a retrospective study

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Abstract

BACKGROUND: Several robotic devices have been proposed for upper limb rehabilitation, but they differ in terms of application fields and the technical solutions implemented.

AIM: The aim of this study was to compare the effectiveness of three different robotic devices for shoulder-elbow rehabilitation in reducing motor impairment and improving motor performance in post-stroke patients.

DESIGN: Retrospective multi-center study.

SETTING: Inpatient rehabilitation hospital.

POPULATION: Eighty-seven chronic and subacute post-stroke patients, aged 48-85 years.

METHODS: Data were obtained through a retrospective analysis of patients who underwent a 3-week rehabilitation program including robot-assisted therapy of the upper limb and conventional physical therapy. Patients were divided into three groups according to the robot device used for exercise training: 'Braccio di Ferro" (BdF), InMotion2 (IMT), and MEchatronic system for MOtor recovery after Stroke (MEMOS). They were evaluated at the beginning and end of treatment using the Fugl-Meyer (FM) and Modified Ashworth (MAS) clinical scales and by a set of robot measured kinematic parameters.

RESULTS: The three groups were homogeneous for age, level of impairment, time since the acute event, and spasticity level. A significant effect of time (P<0.001) was evident on FM and kinematic parameters across all groups. The average change in the FM score was 9.5, 7.3 and 7.1 points, respectively, for BdF, IMT and MEMOS. No significant between-group differences were observed at the MAS pre- vs. post-treatment. A significant interaction between time and groups resulted for the mean velocity (MV, P<0.005) and movement smoothness parameters (nPK, P<0.001 and SM, P<0.02). The effect size (ES) was large for the FM score and MV parameter, independently of the type of robot device used. Further, the ES ranged from moderate to large for the remaining kinematic parameters except for the movement accuracy (mean distance, MD), which exhibited a small ES in the BdF and MEMOS groups.

CONCLUSIONS: The motor function gains obtained during robot-assisted therapy of stroke patients seem to be independent of the type of robot device used for the training program. All devices tested in this study were effective in improving the level of impairment and motor performance.

CLINICAL REHABILITATION IMPACT: This study could help rehabilitation professionals to set-up comparative studies involving rehabilitation technologies.

Original languageEnglish
Pages (from-to)240-248
Number of pages9
JournalEuropean Journal of Physical and Rehabilitation Medicine
Volume53
Issue number2
DOIs
Publication statusPublished - Apr 2017

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Robotics
Upper Extremity
Rehabilitation
Retrospective Studies
Exercise
Equipment and Supplies
Stroke
Biomechanical Phenomena
Therapeutics
Elbow
Inpatients
Technology
Education

Keywords

  • Journal Article

Cite this

@article{a47abc5a9b2143b182a52f64db7142fe,
title = "Comparison of exercise training effect with different robotic devices for upper limb rehabilitation: a retrospective study",
abstract = "BACKGROUND: Several robotic devices have been proposed for upper limb rehabilitation, but they differ in terms of application fields and the technical solutions implemented.AIM: The aim of this study was to compare the effectiveness of three different robotic devices for shoulder-elbow rehabilitation in reducing motor impairment and improving motor performance in post-stroke patients.DESIGN: Retrospective multi-center study.SETTING: Inpatient rehabilitation hospital.POPULATION: Eighty-seven chronic and subacute post-stroke patients, aged 48-85 years.METHODS: Data were obtained through a retrospective analysis of patients who underwent a 3-week rehabilitation program including robot-assisted therapy of the upper limb and conventional physical therapy. Patients were divided into three groups according to the robot device used for exercise training: 'Braccio di Ferro{"} (BdF), InMotion2 (IMT), and MEchatronic system for MOtor recovery after Stroke (MEMOS). They were evaluated at the beginning and end of treatment using the Fugl-Meyer (FM) and Modified Ashworth (MAS) clinical scales and by a set of robot measured kinematic parameters.RESULTS: The three groups were homogeneous for age, level of impairment, time since the acute event, and spasticity level. A significant effect of time (P<0.001) was evident on FM and kinematic parameters across all groups. The average change in the FM score was 9.5, 7.3 and 7.1 points, respectively, for BdF, IMT and MEMOS. No significant between-group differences were observed at the MAS pre- vs. post-treatment. A significant interaction between time and groups resulted for the mean velocity (MV, P<0.005) and movement smoothness parameters (nPK, P<0.001 and SM, P<0.02). The effect size (ES) was large for the FM score and MV parameter, independently of the type of robot device used. Further, the ES ranged from moderate to large for the remaining kinematic parameters except for the movement accuracy (mean distance, MD), which exhibited a small ES in the BdF and MEMOS groups.CONCLUSIONS: The motor function gains obtained during robot-assisted therapy of stroke patients seem to be independent of the type of robot device used for the training program. All devices tested in this study were effective in improving the level of impairment and motor performance.CLINICAL REHABILITATION IMPACT: This study could help rehabilitation professionals to set-up comparative studies involving rehabilitation technologies.",
keywords = "Journal Article",
author = "Roberto Colombo and Fabrizio Pisano and Carmen Delconte and Alessandra Mazzone and Giuseppe Grioni and Marisa Castagna and Giacomo Bazzini and Chiara Imarisio and Giorgio Maggioni and Caterina Pistarini",
year = "2017",
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doi = "10.23736/S1973-9087.16.04297-0",
language = "English",
volume = "53",
pages = "240--248",
journal = "European Journal of Physical and Rehabilitation Medicine",
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TY - JOUR

T1 - Comparison of exercise training effect with different robotic devices for upper limb rehabilitation

T2 - a retrospective study

AU - Colombo, Roberto

AU - Pisano, Fabrizio

AU - Delconte, Carmen

AU - Mazzone, Alessandra

AU - Grioni, Giuseppe

AU - Castagna, Marisa

AU - Bazzini, Giacomo

AU - Imarisio, Chiara

AU - Maggioni, Giorgio

AU - Pistarini, Caterina

PY - 2017/4

Y1 - 2017/4

N2 - BACKGROUND: Several robotic devices have been proposed for upper limb rehabilitation, but they differ in terms of application fields and the technical solutions implemented.AIM: The aim of this study was to compare the effectiveness of three different robotic devices for shoulder-elbow rehabilitation in reducing motor impairment and improving motor performance in post-stroke patients.DESIGN: Retrospective multi-center study.SETTING: Inpatient rehabilitation hospital.POPULATION: Eighty-seven chronic and subacute post-stroke patients, aged 48-85 years.METHODS: Data were obtained through a retrospective analysis of patients who underwent a 3-week rehabilitation program including robot-assisted therapy of the upper limb and conventional physical therapy. Patients were divided into three groups according to the robot device used for exercise training: 'Braccio di Ferro" (BdF), InMotion2 (IMT), and MEchatronic system for MOtor recovery after Stroke (MEMOS). They were evaluated at the beginning and end of treatment using the Fugl-Meyer (FM) and Modified Ashworth (MAS) clinical scales and by a set of robot measured kinematic parameters.RESULTS: The three groups were homogeneous for age, level of impairment, time since the acute event, and spasticity level. A significant effect of time (P<0.001) was evident on FM and kinematic parameters across all groups. The average change in the FM score was 9.5, 7.3 and 7.1 points, respectively, for BdF, IMT and MEMOS. No significant between-group differences were observed at the MAS pre- vs. post-treatment. A significant interaction between time and groups resulted for the mean velocity (MV, P<0.005) and movement smoothness parameters (nPK, P<0.001 and SM, P<0.02). The effect size (ES) was large for the FM score and MV parameter, independently of the type of robot device used. Further, the ES ranged from moderate to large for the remaining kinematic parameters except for the movement accuracy (mean distance, MD), which exhibited a small ES in the BdF and MEMOS groups.CONCLUSIONS: The motor function gains obtained during robot-assisted therapy of stroke patients seem to be independent of the type of robot device used for the training program. All devices tested in this study were effective in improving the level of impairment and motor performance.CLINICAL REHABILITATION IMPACT: This study could help rehabilitation professionals to set-up comparative studies involving rehabilitation technologies.

AB - BACKGROUND: Several robotic devices have been proposed for upper limb rehabilitation, but they differ in terms of application fields and the technical solutions implemented.AIM: The aim of this study was to compare the effectiveness of three different robotic devices for shoulder-elbow rehabilitation in reducing motor impairment and improving motor performance in post-stroke patients.DESIGN: Retrospective multi-center study.SETTING: Inpatient rehabilitation hospital.POPULATION: Eighty-seven chronic and subacute post-stroke patients, aged 48-85 years.METHODS: Data were obtained through a retrospective analysis of patients who underwent a 3-week rehabilitation program including robot-assisted therapy of the upper limb and conventional physical therapy. Patients were divided into three groups according to the robot device used for exercise training: 'Braccio di Ferro" (BdF), InMotion2 (IMT), and MEchatronic system for MOtor recovery after Stroke (MEMOS). They were evaluated at the beginning and end of treatment using the Fugl-Meyer (FM) and Modified Ashworth (MAS) clinical scales and by a set of robot measured kinematic parameters.RESULTS: The three groups were homogeneous for age, level of impairment, time since the acute event, and spasticity level. A significant effect of time (P<0.001) was evident on FM and kinematic parameters across all groups. The average change in the FM score was 9.5, 7.3 and 7.1 points, respectively, for BdF, IMT and MEMOS. No significant between-group differences were observed at the MAS pre- vs. post-treatment. A significant interaction between time and groups resulted for the mean velocity (MV, P<0.005) and movement smoothness parameters (nPK, P<0.001 and SM, P<0.02). The effect size (ES) was large for the FM score and MV parameter, independently of the type of robot device used. Further, the ES ranged from moderate to large for the remaining kinematic parameters except for the movement accuracy (mean distance, MD), which exhibited a small ES in the BdF and MEMOS groups.CONCLUSIONS: The motor function gains obtained during robot-assisted therapy of stroke patients seem to be independent of the type of robot device used for the training program. All devices tested in this study were effective in improving the level of impairment and motor performance.CLINICAL REHABILITATION IMPACT: This study could help rehabilitation professionals to set-up comparative studies involving rehabilitation technologies.

KW - Journal Article

U2 - 10.23736/S1973-9087.16.04297-0

DO - 10.23736/S1973-9087.16.04297-0

M3 - Article

C2 - 27676203

VL - 53

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JO - European Journal of Physical and Rehabilitation Medicine

JF - European Journal of Physical and Rehabilitation Medicine

SN - 1973-9087

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