Robotic techniques for upper limb evaluation and rehabilitation of stroke patients

IEEE Trans Neural Syst Rehabil Eng. 2005 Sep;13(3):311-24. doi: 10.1109/TNSRE.2005.848352.

Abstract

This paper presents two robot devices for use in the rehabilitation of upper limb movements and reports the quantitative parameters obtained to characterize the rate of improvement, thus allowing a precise monitoring of patient's recovery. A one degree of freedom (DoF) wrist manipulator and a two-DoF elbow-shoulder manipulator were designed using an admittance control strategy; if the patient could not move the handle, the devices completed the motor task. Two groups of chronic post-stroke patients (G1 n = 7, and G2 n = 9) were enrolled in a three week rehabilitation program including standard physical therapy (45 min daily) plus treatment by means of robot devices, respectively, for wrist and elbow-shoulder movements (40 min, twice daily). Both groups were evaluated by means of standard clinical assessment scales and a new robot measured evaluation metrics that included an active movement index quantifying the patient's ability to execute the assigned motor task without robot assistance, the mean velocity, and a movement accuracy index measuring the distance of the executed path from the theoretic one. After treatment, both groups improved their motor deficit and disability. In G1, there was a significant change in the clinical scale values (p < 0.05) and range of motion wrist extension (p < 0.02). G2 showed a significant change in clinical scales (p < 0.01), in strength (p < 0.05) and in the robot measured parameters (p < 0.01). The relationship between robot measured parameters and the clinical assessment scales showed a moderate and significant correlation (r > 0.53 p < 0.03). Our findings suggest that robot-aided neurorehabilitation may improve the motor outcome and disability of chronic post-stroke patients. The new robot measured parameters may provide useful information about the course of treatment and its effectiveness at discharge.

Publication types

  • Clinical Trial
  • Controlled Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Chronic Disease
  • Diagnosis, Computer-Assisted / methods*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Motion Therapy, Continuous Passive / methods*
  • Motor Skills
  • Paresis / diagnosis*
  • Paresis / etiology
  • Paresis / rehabilitation*
  • Physical Examination / methods
  • Physical Stimulation / methods
  • Robotics / methods*
  • Stroke / complications
  • Stroke / diagnosis*
  • Stroke Rehabilitation*
  • Therapy, Computer-Assisted / methods*
  • Upper Extremity / physiopathology