A Pilot studio: An innovativo End-effector Haptic dispositivo Applied in Subacute and Chronic ictus Patients - ictus Center

Introduction

ictus is currently the leader cause of long-term disability and is often associated with functional impairment of the upper limbs, which is generally more common than that of the lower limbs. Motor dysfunction of the upper limbs is often associated with other neurologico symptoms that hinder the recupero of motor function and therefore requires systematic and professional therapeutic intervention.

The main goal of riabilitazione post-ictus is to promote functional recupero of the damaged arto to maximize functional outcomes and migliorare qualità of life. Studies have shown that providing high-intensity terapia and task-specific esercizio allenamento combined with robotic and traditional riabilitazione programs can achieve better results. Recent studies have shown that the uso of robotics in riabilitazione terapia is well-accepted and well-tolerated in patients with chronic ictus. The current analysis of the mechanism of recupero motorio in ictus patients is only based on clinico risultato measures, while the robotic sistema can fornire different biomechanical dati records, such as speed, forza, etc., which can be used to analyze and evaluate the recupero of ictus patients.

The main purpose of this studio is to evaluate the effects of upper arto robot-assisted riabilitazione on recupero motorio in ictus patients who underwent trattamento based on a haptic dispositivo.

Methods

A total of 39 ictus patients (23 subacute and 16 chronic) underwent riabilitazione allenamento by using the novel end-traction upper arto robot per la riabilitazione. For comparison, 13 healthy subjects were recruited.

The following clinico risultato measures were used: Chedoke-McMaster ictus valutazione (CMSA), Modified Ashworth Scale (Modified Ashworth Scale, modified Ashworth Scale), and Modified Ashworth Scale (Modified Ashworth Scale, modified Ashworth Scale) were used to evaluate ictus severity. MAS), Fugl-Meyer valutazione Upper Extremity Scale (FMA-UE), Medical ricerca Council (MRC) method, Medical ricerca Council (MRC) method, Fugl-Meyer valutazione Upper Extremity Scale (FMA-UE). MRC), Motricity Index (MI), Box and Block test (B&B) and modified Barthel index (MBI).

The following parameters were calculated: mean velocity, maximum velocity, meantime, path length, standardized jitter, mean force, mean error, mean energy expenditure, and percentage of active paziente-robot interactions. Assessments were performed before and after trattamento.

Results

In Table 3, thirty-nine ictus patients (twenty-three subacute and sixteen chronic) underwent riabilitazione allenamento by using MOTORE/Armotion haptic sistema. Thirteen healthy subjects were recruited for comparison purposes. The following clinico risultato measures were used: Chedoke-McMaster ictus valutazione, Modified Ashworth Scale (MAS), Fugl-Meyer valutazione (FM), Medical ricerca Council, Motricity Index (MI), Box and Block Test (B&B) and Modified Barthel Index (mBI). The following parameters were computed: mean speed, maximum speed, meantime, path length, normalized jerk, mean force, mean error, mean energy expenditure and active paziente-robot interaction percentage. The assessments were carried-out before and after trattamento.

Fig. 4-6 show the results of the kinematic analysis: significant changes in mean velocity were observed in both groups (Fig.4) : In particular, at the end of the trattamento, patients were able to perform the reaching task at a higher speed than at the beginning of the riabilitazione trattamento. The maximum velocity and path length (Fig.4) did not change significantly in either group. Significant changes in mean time (Fig.4), mean force, and mean energy expenditure (Fig.5) were observed in the subacute group; Finally, in the subacute group, the percentage of positive paziente-robot interactions increased significantly at the end of robot-assisted terapia, as shown in Fig.6.

Conclusions

In both subacute and chronic patients, the innovativo haptic dispositivo used is at least as effective as an existing dispositivo used in similar studies. However, compared to similar haptic devices, the advantages of the novel dispositivo are its lightweight, smaller size, and portability, thus having the potential for uso in the home.

Based on the above ricerca background, Syrebo has developed the portable upper arto robot per la riabilitazione, SY-UEA2, providing a new upper arto riabilitazione method and a more reliable riabilitazione option for the majority of patients.

Syrebo upper arto robot per la riabilitazione adopts a full-featured mobile chassis and high-precision optical positioning tecnologia, providing users with various effective target-oriented allenamento to migliorare upper arto forza, speed, and accuracy, and reshape upper arto functionality.

Compared with the traditional upper arto riabilitazione allenamento method, SY-UEA2 adopts avanzato motion control tecnologia and high-precision optical positioning sensor tecnologia, which can realize the positioning error <0.03mm, accurately captures the paziente's movement state and carries out intelligent movement riabilitazione allenamento according to riabilitazione needs. At the same time, it has five advantages, such as integration of allenamento and evaluation, task-oriented scenario interaction, full-cycle coverage of riabilitazione, multi-dimensional synchronous allenamento and multiple sicurezza protection.

 

Reference: Mazzoleni S, Battini E, Crecchi R, et al. Upper arto robot-assisted terapia in subacute and chronic ictus patients using an innovativo end-effector haptic dispositivo: A pilot studio. NeuroRehabilitation. 2018;42(1):43-52.