scholarly journals Improving the Efficiency of Robot-Mediated Rehabilitation by Using a New Organizational Model: An Observational Feasibility Study in an Italian Rehabilitation Center

2019 ◽  
Vol 9 (24) ◽  
pp. 5357 ◽  
Author(s):  
Irene Aprile ◽  
Cristiano Pecchioli ◽  
Simona Loreti ◽  
Arianna Cruciani ◽  
Luca Padua ◽  
...  
Keyword(s):  
Upper Limb ◽  
Rehabilitation Center ◽  
Organizational Model ◽  
Organizational Models ◽  
Robotic Rehabilitation ◽  
Robot Assisted ◽  
Participant Satisfaction ◽  
Upper Limb Function ◽  
Proposed Model ◽  
The Mean

Robotic rehabilitation is a promising way to restore upper limb function, but new organizational models are crucial in order to improve its sustainability. We aimed to analyze the feasibility of a robot-Assisted REhabilitation Area (robotAREA) equipped with four devices, using a new organizational model in which one physiotherapist supervises up to four patients. In 33 days, 60 patients were treated in the robotAREA. Two hundred fifty-five rehabilitation sessions were analyzed, each including two, three, or four patients supervised by one physiotherapist (the R2, R3, and R4 group, respectively). For each session, the duration of (a) setup, (b) training, (c) supervision, (d) session closure, and participant satisfaction were measured. For each patient, upper limb impairment, disability, mobility, and comorbidity were recorded. The time of training in the R4 group was lower by only 2 and 3 min compared to the R2 and R3 groups, respectively, while the supervision significantly changed between the R2, R3, and R4 groups. No differences were observed in satisfaction. Moreover, according to the logistic regression analysis, when the mean disability of the group is moderate, four patients can be supervised by one physiotherapist. These results suggest that the proposed model is feasible, and the mean disability of the group could influence the proper physiotherapist/patient ratio.

scholarly journals Effect of Self-care Training on Upper Limb Function and Pain After Breast Cancer Surgery

2021 ◽  
Vol 10 (2) ◽  
Author(s):  
Somyye Noura ◽  
Fatemeh Kiani ◽  
Nezarali Moulaei ◽  
Mojtaba Tasbandi ◽  
Ebrahim Ebrahimi Tabas
Keyword(s):  
Breast Cancer ◽  
Upper Limb ◽  
Intervention Group ◽  
Self Care ◽  
Control Group ◽  
Limb Function ◽  
Upper Limb Function ◽  
Care Training ◽  
The Mean ◽  
And Control

Background: Breast cancer patients who undergo mastectomy encounter numerous problems, the most annoying of which is lymphedema followed by pain and decreased function in the affected limb. Objectives: This study examined the effect of self-care training on upper limb function and pain after breast surgery. Methods: This quasi-experimental study was performed on two groups of 60 patients with breast cancer in the Oncology Ward of Zahedan University of Medical Sciences in 2021. The patients were selected based on the inclusion criteria and through convenience sampling and were then randomly divided into intervention and control groups. The patients in the intervention group attended self-care training and exercise programs implemented in five sessions in addition to the routine care. One and three months after the intervention, upper limb function and pain were measured with DASH and McGill pain questionnaires. The repeated measures analysis of variance (ANOVA) and Bonferroni test were used to compare the pre-, and post-intervention mean scores and mean differences in the two groups. Results: The mean scores of upper limb function one and three months after the training program in the intervention group were lower than the mean scores of the control group. In other words, the quality of upper limb function was not significantly different despite the changes in the first month, but upper limb function significantly improved three months after the intervention (P < 0.001 vs. P = 0.06). The mean pain scores before, one month, and three months after the intervention in the intervention group were 10.4, 35.7, and 6.26, respectively, and the corresponding values in the control group were 10.8, 41.7, and 21.1, respectively, showing significant differences between the two groups, with the intervention group having lower pain scores than the control group (P = 0.001). Conclusions: Since lymphedema and its consequences, including decreased upper limb function and pain, are very serious issues, medical staff can give priority to this training program and implement it to prevent and control these complications.

scholarly journals Feasibility of Robot-assisted Rehabilitation in Poststroke Recovery of Upper Limb Function Depending on the Severity

2020 ◽  
Vol 60 (4) ◽  
pp. 217-222
Author(s):  
Kazuya SAITA ◽  
Takashi MORISHITA ◽  
Koichi HYAKUTAKE ◽  
Toshiyasu OGATA ◽  
Hiroyuki FUKUDA ◽  
...  
Keyword(s):  
Upper Limb ◽  
Robot Assisted ◽  
Limb Function ◽  
Upper Limb Function

scholarly journals Quantification of Upper Limb Motor Recovery and EEG Power Changes after Robot-Assisted Bilateral Arm Training in Chronic Stroke Patients: A Prospective Pilot Study

2018 ◽  
Vol 2018 ◽  
pp. 1-15 ◽  
Author(s):  
Marialuisa Gandolfi ◽  
Emanuela Formaggio ◽  
Christian Geroin ◽  
Silvia Francesca Storti ◽  
Ilaria Boscolo Galazzo ◽  
...  
Keyword(s):  
Upper Limb ◽  
Chronic Stroke ◽  
Active Movement ◽  
Stroke Patients ◽  
Robot Assisted ◽  
Sensorimotor Network ◽  
Upper Limb Function ◽  
Eeg Power ◽  
Beta Frequency ◽  
Bilateral Arm Training

Background. Bilateral arm training (BAT) has shown promise in expediting progress toward upper limb recovery in chronic stroke patients, but its neural correlates are poorly understood.Objective. To evaluate changes in upper limb function and EEG power after a robot-assisted BAT in chronic stroke patients.Methods. In a within-subject design, seven right-handed chronic stroke patients with upper limb paresis received 21 sessions (3 days/week) of the robot-assisted BAT. The outcomes were changes in score on the upper limb section of the Fugl-Meyer assessment (FM), Motricity Index (MI), and Modified Ashworth Scale (MAS) evaluated at the baseline (T0), posttraining (T1), and 1-month follow-up (T2). Event-related desynchronization/synchronization were calculated in the upper alpha and the beta frequency ranges.Results. Significant improvement in all outcomes was measured over the course of the study. Changes in FM were significant at T2, and in MAS at T1and T2. After training, desynchronization on the ipsilesional sensorimotor areas increased during passive and active movement, as compared with T0.Conclusions. A repetitive robotic-assisted BAT program may improve upper limb motor function and reduce spasticity in the chronically impaired paretic arm. Effects on spasticity were associated with EEG changes over the ipsilesional sensorimotor network.

scholarly journals Upper limb function and functional independence in patients with shoulder pain after stroke

2017 ◽  
Vol 75 (2) ◽  
pp. 103-106 ◽  
Author(s):  
Renato Nickel ◽  
Marcos Lange ◽  
Diane Priscila Stoffel ◽  
Elaine Janeczko Navarro ◽  
Viviane F Zetola
Keyword(s):  
Shoulder Pain ◽  
Upper Limb ◽  
Stroke Patient ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Stroke Patients ◽  
Pain Group ◽  
Limb Function ◽  
Upper Limb Function ◽  
The Mean

ABSTRACT Objective To examine the frequency of shoulder pain following stroke. Methods Stroke patient function was evaluated using the Functional Independence Measure (FIM) and Scale for Upper Limb Function in Stroke (SULFS). Function scores were examined and compared between the shoulder pain group (SPG) and the no shoulder pain group (No-SPG). Results A total of 58 patients, 22 women (37.9%), were included in this study. The mean patient age was 49.2±10.8 years and study evaluations were done 3.52±2.26 months after stroke. A total of 16 patients (27.6%) were in the SPG and 42 patients (72.4%) were in the No-SPG. The SPG scored significantly lower on the FIM (SPG: 91.06±14.65 vs. No-SPG 114.62 ± 2.27; p < 0.01) and SULFS (SPG median: 2 [range: 1-4], No-SPG median: 5 [range: 1-5]; p < 0.01) than the No-SPG. Conclusion Shoulder pain commonly occurs after stroke and is related to the affected upper limb function and functional independence in stroke patients.

scholarly journals Combining Upper Limb Robotic Rehabilitation with Other Therapeutic Approaches after Stroke: Current Status, Rationale, and Challenges

2017 ◽  
Vol 2017 ◽  
pp. 1-11 ◽  
Author(s):  
Stefano Mazzoleni ◽  
Christophe Duret ◽  
Anne Gaëlle Grosmaire ◽  
Elena Battini
Keyword(s):  
Upper Limb ◽  
Neural Substrates ◽  
Current Status ◽  
Therapeutic Approaches ◽  
Motor Impairments ◽  
Robotic Rehabilitation ◽  
Noninvasive Brain Stimulation ◽  
Upper Limb Function ◽  
Robotic Devices ◽  
Botulinum Toxin Injections

A better understanding of the neural substrates that underlie motor recovery after stroke has led to the development of innovative rehabilitation strategies and tools that incorporate key elements of motor skill relearning, that is, intensive motor training involving goal-oriented repeated movements. Robotic devices for the upper limb are increasingly used in rehabilitation. Studies have demonstrated the effectiveness of these devices in reducing motor impairments, but less so for the improvement of upper limb function. Other studies have begun to investigate the benefits of combined approaches that target muscle function (functional electrical stimulation and botulinum toxin injections), modulate neural activity (noninvasive brain stimulation), and enhance motivation (virtual reality) in an attempt to potentialize the benefits of robot-mediated training. The aim of this paper is to overview the current status of such combined treatments and to analyze the rationale behind them.

scholarly journals The Effect of Applying Robot-Assisted Task-Oriented Training Using Human-Robot Collaborative Interaction Force Control Technology on Upper Limb Function in Stroke Patients: Preliminary Findings

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Qingming Qu ◽  
Yingnan Lin ◽  
Zhijie He ◽  
Jianghong Fu ◽  
Fei Zou ◽  
...  
Keyword(s):  
Upper Limb ◽  
Force Control ◽  
Interaction Force ◽  
Control Technology ◽  
Stroke Patients ◽  
Robot Assisted ◽  
Limb Function ◽  
Upper Limb Function ◽  
Collaborative Interaction ◽  
Clinical Experiments

Stroke is one of the leading causes of death and the primary cause of acquired disability worldwide. Many stroke survivors have difficulty using their upper limbs, which have important functional roles in the performance of daily life activities. Consequently, the independence and quality of life of most stroke patients are reduced. Robot-assisted therapy is an effective intervention for improving the upper limb function of individuals with stroke. Human-robot collaborative interaction force control technology is critical for improving the flexibility and followability of the robot’s motion, thereby improving rehabilitation training outcomes. However, there are few reports on the effect of robot-assisted rehabilitative training on upper limb function. We applied this technology using a robot to assist patients with task-oriented training. Posttreatment changes in Fugl-Meyer and modified Barthel index (MBI) scores were assessed to determine whether this technology could improve the upper limb function of stroke patients. One healthy adult and five stroke patients, respectively, participated in functional and clinical experiments. The MBI and Fugl-Meyer scores of the five patients in the clinical experiments showed significant improvements after the intervention. The experimental results indicate that human-robot collaborative interaction force control technology is valuable for improving robots’ properties and patients’ recovery. This trial was registered in the Chinese clinical trial registry (ChiCTR2000038676).

scholarly journals A RANDOMIZED CONTROLLED TRIAL ON THE EFFECTS OF OCCUPATIONAL THERAPY INTERVENTIONS USING PATIENT-CENTERED ROBOT-ASSISTED REHABILITATION FOR FUNCTIONAL IMPROVEMENT IN SUBACUTE STROKE PATIENTS

2021 ◽  
pp. 2140040
Author(s):  
DAESEOK YOON ◽  
SEUNGBOK LEE ◽  
SANG-HYUN CHO ◽  
HAEYEAN PARK ◽  
JONGBAE KIM
Keyword(s):  
Upper Limb ◽  
Controlled Trial ◽  
Stroke Patients ◽  
Robot Assisted ◽  
Patient Centered ◽  
Limb Function ◽  
Randomized Controlled ◽  
Upper Limb Function ◽  
Experimental Group ◽  
Adl Performance

The objective of this research study was to investigate the effect of patient-centered robot-assisted intervention for upper limb function improvement in stroke patients. Design: A double-blind randomized controlled trial. Intervention: Subjectively preferred areas of need for performing daily activities were identified by pre-interviewing and applied as target goals in the experimental group using a robotic device. Control-1 underwent a program focused on the robot system involving movements of upper limb joints. Control-2 participated in a conventional rehabilitation program. Methods: Forty-five participants engaged in 60 min of daily therapy, five times weekly for 3 weeks. The experimental group used the Canadian occupational performance measure (COPM) to identify subjectively preferred “patient-centered” focus needed areas to perform robotic device aided daily activities. Control-1 used a robot device-focused rehabilitation involving upper limb joint movements. Control-2 participated in conventional rehabilitation. Pre-post intervention measurements of hand, grip, power, and upper limb ROM were acquired by FMA-UE, MFT, and K-MBI. Results: A significant increase of function in the experimental group was observed in each subclass of function and activities of daily living (ADL) performance. Control-1 showed an increase in function without ADL improvement. Control-2 showed an increase in ADL and proximal areas of upper limb function without an increase in other areas. Conclusion: The “patient-centered” approach significantly improved upper limb function and ADL performance compared to “robot-centered” rehabilitation. Further studies are warranted to confirm these results and for generalizability in clinical application.

scholarly journals Suspensionplasty using Anchors and Non-Absorbable Sutures for Rhizarthrosis

2018 ◽  
Vol 46 (02) ◽  
pp. 087-095
Author(s):  
Samuel Ribak ◽  
Giovanna de Carvalho ◽  
Ricardo de Oliveira
Keyword(s):  
Surgical Treatment ◽  
Upper Limb ◽  
Daily Living ◽  
Professional Activity ◽  
Absorbable Suture ◽  
Joint Movement ◽  
Limb Function ◽  
Daily Living Activities ◽  
Upper Limb Function ◽  
The Mean

Objective To analyze the clinical and radiographic results of patients with rhizarthrosis who underwent surgical treatment for resection of the trapezium bone using a fixation system with anchors and a non-absorbable suture. Methods Fifteen patients with a mean age of 60.26 years old were studied. Fourteen patients had type III rhizarthrosis and 1 had type II rhizarthrosis, according to the Eaton-Littler classification. Data on the professional activity, affected side, and hand dominance were collected and evaluated for the presence of pain, degree of joint movement of the radial abduction of the thumb, opposition, and palmar grip strength. The upper limb function was assessed using the Quick Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire. The patients were subjected to pre and postoperative radiographic examinations, by which the scaphoid-first metacarpal height was measured using the oblique view of the hand. Suspensionplasty by fixation was then performed using a system of two 2.0 mm threaded bone anchors and a 2.0 mm Ethibond (Ethicon, Inc., Somerville, NJ, USA) suture wire. Finally, the trapezium bone was resected. Results The mean follow-up duration was 21.50 ± 5.02 months. The patients showed a mean score of 1.6 in the final evaluation using the visual analog scale. The degree of joint movement of the abduction of the thumb was on average 61.67° postoperatively and 59.73° preoperatively. There was an improvement in thumb opposition and a significant improvement in the upper limb function, as assessed using the Quick DASH method. The scaphoid-first metacarpal height had a proximal migration of ∼ 50% in the postoperative radiographs. The mean time to return to daily living activities was 20.7 days, 24.7 days to practical life activities, and 101.3 days to work activities. There was no correlation between the level of professional activity and the incidence of the disease. Conclusions Trapeziectomy and suspensionplasty, using an anchorage system and a non-absorbable suture, shows a significant improvement in pain, opposition, and function of the affected upper limb, and is efficient for the surgical treatment of rhizarthrosis. It allows for a rapid return to daily living activities with a low risk for complications.

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