Does hand robotic rehabilitation improve motor function by rebalancing interhemispheric connectivity after chronic stroke? Encouraging data from a randomised-clinical-trial

Rocco Salvatore Calabrò, Maria Accorinti, Bruno Porcari, Luigi Carioti, Laura Ciatto, Luana Billeri, Veronica Agata Andronaco, Franco Galletti, Serena Filoni, Antonino Naro

Research output: Contribution to journalArticle

Abstract

Objective: The objective of this study was the evaluation of the clinical and neurophysiological effects of intensive robot-assisted hand therapy compared to intensive occupational therapy in the chronic recovery phase after stroke. Methods: 50 patients with a first-ever stroke occurred at least six months before, were enrolled and randomised into two groups. The experimental group was provided with the Amadeo™ hand training (AHT), whereas the control group underwent occupational therapist-guided conventional hand training (CHT). Both of the groups received 40 hand training sessions (robotic and conventional, respectively) of 45 min each, 5 times a week, for 8 consecutive weeks. All of the participants underwent a clinical and electrophysiological assessment (task-related coherence, TRCoh, and short-latency afferent inhibition, SAI) at baseline and after the completion of the training. Results: The AHT group presented improvements in both of the primary outcomes (Fugl-Meyer Assessment for of Upper Extremity and the Nine-Hole Peg Test) greater than CHT (both p < 0.001). These results were paralleled by a larger increase in the frontoparietal TRCoh in the AHT than in the CHT group (p < 0.001) and a greater rebalance between the SAI of both the hemispheres (p < 0.001). Conclusions: These data suggest a wider remodelling of sensorimotor plasticity and interhemispheric inhibition between sensorimotor cortices in the AHT compared to the CHT group. Significance: These results provide neurophysiological support for the therapeutic impact of intensive robot-assisted treatment on hand function recovery in individuals with chronic stroke.

Original languageEnglish
Pages (from-to)767-780
Number of pages14
JournalClinical Neurophysiology
Volume130
Issue number5
DOIs
Publication statusPublished - May 2019

Keywords

  • Amadeo™
  • Frontoparietal connectivity
  • Hand rehabilitation
  • Sensorimotor plasticity

ASJC Scopus subject areas

  • Sensory Systems
  • Neurology
  • Clinical Neurology
  • Physiology (medical)

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