Robot-aided neurorehabilitation in sub-acute and chronic stroke: Does spontaneous recovery have a limited impact on outcome?

R. Colombo, I. Sterpi, A. Mazzone, C. Delconte, F. Pisano

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Robotic neurorehabilitation, thanks to high dosage/intensity training protocols, has the potential for a greater impact on impairment. OBJECTIVE: We aimed to analyze how time since the acute event may influence the motor recovery process during robot-assisted rehabilitation of the upper limb. METHODS: A total of 41 patients after stroke were enrolled: 20 in subacute phase, i.e. ≤ 6 months elapsed since their unilateral cerebrovascular accident (CVA), and 21 at chronic stage, i.e. > 6 months since CVA. All subjects underwent 30 minutes of robot-aided rehabilitation twice a day, 5 days a week for at least three weeks of training. Patients were evaluated at the start and end of treatment using the Fugl-Meyer and Modified Ashworth clinical scales and by a set of robot measured kinematic parameters. The time interval from stroke was considered as a grouping factor to analyze its impact on time course of recovery. RESULTS: After training both groups significantly improved their impairment (F = 44.25, p <0.001) but sub-acute patients showed a greater improvement on the Fugl-Meyer scale than chronic patients. The time course of recovery of the kinematic variables showed higher time constants of motor improvement in the sub-acute than chronic group, but they were one order lower than spontaneous recovery time constants. CONCLUSIONS: Spontaneous recovery seems to have a limited impact on the improvement of sub-acute patients, most of their changes being likely due to re-learning during rehabilitation. In addition, a longer recovery time was required to maximize outcome in sub-acute than in chronic patients.

Original languageEnglish
Pages (from-to)621-629
Number of pages9
JournalNeuroRehabilitation
Volume33
Issue number4
DOIs
Publication statusPublished - 2013

Keywords

  • motor recovery
  • neurorehabilitation
  • Robotic therapy
  • spontaneous recovery
  • stroke

ASJC Scopus subject areas

  • Clinical Neurology
  • Rehabilitation
  • Physical Therapy, Sports Therapy and Rehabilitation

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