scholarly journals Predicting Clinically Significant Improvement After Robot-Assisted Upper Limb Rehabilitation in Subacute and Chronic Stroke

2021 ◽  
Vol 12 ◽  
Author(s):  
Jae Joon Lee ◽  
Joon-Ho Shin
Keyword(s):  
Prediction Model ◽  
Upper Limb ◽  
Statistical Significance ◽  
Hand Movement ◽  
Chronic Stroke ◽  
Robot Assisted ◽  
Subacute Stroke ◽  
Clinically Significant ◽  
Motor Improvement ◽  
Significant Motor

Prior studies examining predictors of favorable clinical outcomes after upper limb robot-assisted therapy (RT) have many shortcomings. Therefore, the aim of this study was to identify meaningful predictors and a prediction model for clinically significant motor improvement in upper limb impairment after RT for each stroke phase. This retrospective, single-center study enrolled patients with stroke who received RT using InMotion2 along with conventional therapy (CT) from January 2015 to September 2019. Demographic characteristics, clinical measures, and robotic kinematic measures were evaluated. The primary outcome measure was the Fugl-Meyer Assessment-Upper Extremity (FMA-UE) and we classified patients with improvement more than the minimal clinically important difference as responders for each stroke phase. Univariable and multivariable logistic regression analyses were performed to assess the relationship between potential predictors and RT responders and determine meaningful predictors. Subsequently, meaningful predictors were included in the final prediction model. One hundred forty-four patients were enrolled. The Hand Movement Scale and time since onset were significant predictors of clinically significant improvement in upper limb impairment (P = 0.045 and 0.043, respectively), as represented by the FMA-UE score after RT along with CT, in patients with subacute stroke. These variables were also meaningful predictors with borderline statistical significance in patients with chronic stroke (P = 0.076 and 0.066, respectively). Better hand movement and a shorter time since onset can be used as realistic predictors of clinically significant motor improvement in upper limb impairment after RT with InMotion2 alongside CT in patients with subacute and chronic stroke. This information may help healthcare professionals discern optimal patients for RT and accurately inform patients and caregivers about outcomes of RT.

scholarly journals Upper limb motor improvement in chronic stroke after combining botulinum toxin A injection and multi-joints robot-assisted therapy: a case report

2019 ◽  
Vol 2019 (10) ◽  
Author(s):  
Alex Martino Cinnera ◽  
Alessandra Pucello ◽  
Alessandro Lupo ◽  
Francesca Gimigliano ◽  
Elisa Mammucari ◽  
...  
Keyword(s):  
Botulinum Toxin ◽  
Upper Limb ◽  
Daily Living ◽  
Botulinum Toxin A ◽  
Botulinum Toxin Type A ◽  
Botulinum Toxin Type ◽  
Chronic Stroke ◽  
Robot Assisted ◽  
Robotic Therapy ◽  
Motor Improvement

Abstract Spasticity is one of the major complications after stroke. Botulinum toxin type A (BoNT-A) injection is commonly used to manage focal spasticity. However, it is uncertain whether BoNT-A can improve activities of daily living function of paretic arm. The recovery of functions of the affected arm is also the aim of robotic upper limb (UL) therapy. The motorized exoskeleton assists the patient in a large 3D work environment by promoting movement for the UL (shoulder, elbow, wrist, hand). The combination of the BoNT-A injection and the robotic therapy might enhance functional recovery after stroke. We reported the case of a chronic stroke patient in which the injection of BoNT-A was combined with multi-joint exoskeleton training. The patient showed improvement in the motor control of the UL, supporting the feasibility of this approach.

Upper limb robot-assisted therapy in subacute and chronic stroke patients using an innovative end-effector haptic device: A pilot study

2018 ◽  
Vol 42 (1) ◽  
pp. 43-52 ◽  
Author(s):  
S. Mazzoleni ◽  
E. Battini ◽  
R. Crecchi ◽  
P. Dario ◽  
F. Posteraro
Keyword(s):  
Pilot Study ◽  
Upper Limb ◽  
Chronic Stroke ◽  
Haptic Device ◽  
Stroke Patients ◽  
Robot Assisted ◽  
End Effector

Effects of proximal and distal robot-assisted upper limb rehabilitation on chronic stroke recovery

2013 ◽  
Vol 33 (1) ◽  
pp. 33-39 ◽  
Author(s):  
Stefano Mazzoleni ◽  
Patrizio Sale ◽  
Marco Franceschini ◽  
Samuele Bigazzi ◽  
Maria Chiara Carrozza ◽  
...  
Keyword(s):  
Upper Limb ◽  
Chronic Stroke ◽  
Stroke Recovery ◽  
Robot Assisted ◽  
Upper Limb Rehabilitation ◽  
Limb Rehabilitation

Upper limb robot-assisted rehabilitation versus physical therapy on subacute stroke patients: A follow-up study

2020 ◽  
Vol 24 (1) ◽  
pp. 194-198 ◽  
Author(s):  
Marco Franceschini ◽  
Stefano Mazzoleni ◽  
Michela Goffredo ◽  
Sanaz Pournajaf ◽  
Daniele Galafate ◽  
...  
Keyword(s):  
Physical Therapy ◽  
Upper Limb ◽  
Stroke Patients ◽  
Robot Assisted ◽  
Follow Up Study ◽  
Subacute Stroke

Quantitative EEG for Predicting Upper Limb Motor Recovery in Chronic Stroke Robot-Assisted Rehabilitation

2017 ◽  
Vol 25 (7) ◽  
pp. 1058-1067 ◽  
Author(s):  
Paula Trujillo ◽  
Alfonso Mastropietro ◽  
Alessandro Scano ◽  
Andrea Chiavenna ◽  
Simona Mrakic-Sposta ◽  
...  
Keyword(s):  
Upper Limb ◽  
Quantitative Eeg ◽  
Chronic Stroke ◽  
Motor Recovery ◽  
Robot Assisted

scholarly journals β-Oscillations Reflect Recovery of the Paretic Upper Limb in Subacute Stroke

2020 ◽  
Vol 34 (5) ◽  
pp. 450-462 ◽  
Author(s):  
Chih-Wei Tang ◽  
Fu-Jung Hsiao ◽  
Po-Lei Lee ◽  
Yun-An Tsai ◽  
Ya-Fang Hsu ◽  
...  
Keyword(s):  
Motor Function ◽  
Upper Limb ◽  
Primary Motor Cortex ◽  
Hand Movement ◽  
Stroke Recovery ◽  
Stroke Survivors ◽  
Healthy Controls ◽  
Functional Changes ◽  
Post Stroke ◽  
Subacute Stroke

Background. Recovery of upper limb function post-stroke can be partly predicted by initial motor function, but the mechanisms underpinning these improvements have yet to be determined. Here, we sought to identify neural correlates of post-stroke recovery using longitudinal magnetoencephalography (MEG) assessments in subacute stroke survivors. Methods. First-ever, subcortical ischemic stroke survivors with unilateral mild to moderate hand paresis were evaluated at 3, 5, and 12 weeks after stroke using a finger-lifting task in the MEG. Cortical activity patterns in the β-band (16-30 Hz) were compared with matched healthy controls. Results. All stroke survivors (n=22; 17 males) had improvements in action research arm test (ARAT) and Fugl-Meyer upper extremity (FM-UE) scores between 3 and 12 weeks. At 3 weeks post-stroke the peak amplitudes of the movement-related ipsilesional β-band event-related desynchronization (β-ERD) and synchronization (β-ERS) in primary motor cortex (M1) were significantly lower than the healthy controls (p<0.001) and were correlated with both the FM-UE and ARAT scores (r=0.51-0.69, p<0.017). The decreased β-ERS peak amplitudes were observed both in paretic and non-paretic hand movement particularly at 3 weeks post-stroke, suggesting a generalized disinhibition status. The peak amplitudes of ipsilesional β-ERS at week 3 post-stroke correlated with the FM-UE score at 12 weeks (r=0.54, p=0.03) but no longer significant when controlling for the FM-UE score at 3 weeks post-stroke. Conclusions. Although early β-band activity does not independently predict outcome at 3 months after stroke, it mirrors functional changes, giving a potential insight into the mechanisms underpinning recovery of motor function in subacute stroke.

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