Post-stroke robotic training of the upper limb: a randomizedtrial study (preliminary results)

Introduction. Robot therapy can be a promise in rehabilitation treatment in post-stroke patients; the aim of our study was to asses a rehabilitation protocol that allows to directly comparing the effectiveness of the robot therapy (by NeReBot developed at Padua University) to the traditional rehabilitation treatment. Materials and methods. Ten hemiparetic patients after a mean of 14.5 (SD 5.5) after a unilateral, ischemic embolic, or thrombotic stroke (mean age 71.2 (6.1) y.; 7 male and 3 female) were randomized in the experimental group (EG; n=5) and the control group (CG; n=5). Patients of both groups received the same length per day of treatment time (120 minutes) for five days a week and for five weeks. The daily treatment (120 minutes) in the EG included traditional rehabilitation therapy (for a ratio of 65%) and robotic therapy (for a ratio of 35%): robotic sessions will last an average of 20 minutes, twice a day that consisted of peripheral manipulation of the shoulder and elbow of the impaired limb, correlated with visual stimuli. The CG will receive only the traditional rehabilitation treatment. Clinical evaluation were performed at the baseline, after 5 weeks (i.e., at the end of treatment protocol) and 3 months after the beginning of the rehabilitation treatment with: 1) Medical Research Council for deltoid, biceps and triceps, wrist flexors and wrist extension muscles; 2) Fugl-Meyer Assessment for shoulder/elbow and coordination and wrist/hand subsections; 3) Motor-Functional Independent Measure; 4) box and block test; 5) a questionnaire of acceptance NeReBot therapy (1-10; 10 maximum acceptance). Results. The 2 groups were comparable in demographic characteristics and no significative differences were found in pre-treatment clinical evaluations. Compared with the patients in the CG, the EG showed not significant difference in motor impairment and functional recovery of the upper limb, as measured in all the clinical assessment at the end of rehabilitation treatment protocol and at 3-months follow. The questionnaire administered to the EG patients at the end of robot therapy showed that this form of intervention was well accepted and tolerated (mean score, 7,5/10) and all patients were in favor of including NeReBot training in rehabilitation program. Conclusion. Specific sensorimotor stimulation by NeReBot appears to lead an improvement to motor and functional outcome in the impaired upper limb, similarly to the traditional rehabilitation treatment and the improvement persists at the 3-month follow-up. On the base of our preliminary results, robotic therapy by NeReBot may therefore effectively complement standard rehabilitation in paretic upper limb post-stroke patients