Robot-Assisted Training for Upper Limb in Stroke (ROBOTAS): An Observational, Multicenter Study to Identify Determinants of Efficacy

Journal of Clinical Medicine

Stefano Mazzoleni¹  Sanaz Pournajaf²  Marco Franceschini²  Nicola Smania³  Marialuisa Gandolfi³  Serena Filoni⁴  Giovanni Taveggia⁵  Rocco Salvatore Calabrò⁶  Irene Aprile⁷  Stefano Paolucci⁸  Giovanni Morone⁸  Donatella Bonaiuti⁹  Sofia Straudi^1,10  Lucia Tedesco^1,11  Maria Rosaria Leo^1,12  Claudia Zanetti^1,12  Antonella Focacci^1,13  Carmelo Chisari^1,14  Vincenzo Spina^1,14  Antonino Naro^1,15  Carlo D’aurizio^1,16  Vitalma Liotti^1,16 

[1] Department of Electrical and Information Engineering, Politecnico di Bari, Via Edoardo Orabona, 4, 70126 Bari, Italy;Department of Neurological and Rehabilitation Sciences, IRCCS San Raffaele Roma, 00163 Rome, Italy;Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Via S. Francesco, 22, 37129 Verona, Italy;Fondazione Centri di Riabilitazione Padre Pio ONLUS, Presidio “Gli Angeli di Padre Pio”, Viale Padre Pio, 24, 71013 San Giovanni Rotondo, Italy;Habilita Istituto Clinico di Riabilitazione, Via P. A. Faccanoni, 6, 24067 Sarnico, Italy;IRCCS Centro Neurolesi Bonino-Pulejo P.O Piemonte, Viale Europa, 98124 Messina, Italy;IRCCS Fondazione Don Carlo Gnocchi ONLUS, Via di Scandicci 269, 50143 Florence, Italy;IRCCS Fondazione Santa Lucia, Via Ardeatina, 306/354, 00179 Roma, Italy;Italian Society of Physical Medicine and Rehabilitation, Italy;Neuroscience and Rehabilitation Department, Ferrara University Hospital, 44121 Ferrara, Italy;Physical and Rehabilitation Medicine, San Gerardo Hospital, 20900 Monza, Italy;Presidio Ospedaliero Accreditato Casa di Cura Villa Bellombra, Via Bellombra, 24, 40136 Bologna, Italy;Riabilitazione Intensiva Neurologica, S.C. Medicina Fisica e Riabilitazione Ospedaliera ASL4 Liguria, 16034 Sestri Levante, GE, Italy;SD Neuroriabilitazione, Azienda Ospedaliero, Universitaria Pisana, 56121 Pisa, Italy;Stroke Unit, Policlinico Universitario Messina, 98124 Messina, Italy;UOC Medicina Fisica e Riabilitativa ASL di Pescara, 65124 Pescara, Italy;

关键词: robot-assisted therapy;    stroke;    exoskeleton;    rehabilitation;    upper limp therapy;   

DOI  :  10.3390/jcm10225245

来源: DOAJ

【 摘 要 】

Background: The loss of arm function is a common and disabling outcome after stroke. Robot-assisted upper limb (UL) training may improve outcomes. The aim of this study was to explore the effect of robot-assisted training using end-effector and exoskeleton robots on UL function following a stroke in real-life clinical practice. Methods: A total of 105 patients affected by a first-ever supratentorial stroke were enrolled in 18 neurorehabilitation centers and treated with electromechanically assisted arm training as an add-on to conventional therapy. Both interventions provided either an exoskeleton or an end-effector device (as per clinical practice) and consisted of 20 sessions (3/5 times per week; 6–8 weeks). Patients were assessed by validated UL scales at baseline (T0), post-treatment (T1), and at three-month follow-up (T2). The primary outcome was the Fugl-Meyer Assessment for the upper extremity (FMA-UE). Results: FMA-UE improved at T1 by 6 points on average in the end-effector group and 11 points on average in the exoskeleton group (p < 0.0001). Exoskeletons were more effective in the subacute phase, whereas the end-effectors were more effective in the chronic phase (p < 0.0001). Conclusions: robot-assisted training might help improve UL function in stroke patients as an add-on treatment in both subacute and chronic stages. Pragmatic and highmethodological studies are needed to confirm the showed effectiveness of the exoskeleton and end-effector devices.

【 授权许可】

Unknown