A novel robotic device in Neuro-Rehabilitation

Objective The main goal of this work is to investigate whether early therapy with NeReBot (NEuro-REhabilitation-roBOt), a novel robotic device, can reduce motor impairment and enhance functional recovery of poststroke patients with hemiparetic/hemiplegic upper limb. Methods Thirty patients with acute (1week of onset) ischemic stroke that received a standard rehabilitation were randomly assigned to 2 groups: the experimental group (n=15) received additional early sensorimotor robotic training, 4 hours a week for 4 weeks; the control group (n=15) was exposed to the robotic device without training. Training by robot consisted of peripheral manipulation of the shoulder and elbow of the impaired limb, correlated with visual stimuli. Outcomes were evaluated by the same masked raters with Fugl-Meyer Assessment (FMA) of upper-extremity function, Medical Research Council (MRC) score, Functional Indipendent Measure (FIM) and its motor component (motFIM). Results Compared with the patients in the control group, the experimental group showed significant gains in motor impairment and functional recovery of the upper limb after robot therapy, as measured by the MRC deltoid (P.05) and biceps (P<.05) scores, the FMA for the proximal upper arm (P<.05), the FIM (P<.05), and the motFIM score (P<.01); these gains were also sustained at the 8-month follow-up. Conclusions According to clinical results, NeReBot therapy may efficaciously complement standard post-stroke rehabilitation. Our device can (1) perform spatial movements of shoulder and elbow, (2) be easily moved to the hospital room and used for early training, and (3) be used to intervene on patients not only in the sitting but also in the supine position.