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Robotic techniques for upper limb evaluation and rehabilitation of stroke patients

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8 Author(s)

This paper presents two robot devices for use in the rehabilitation of upper limb movements and reports the quantitative parameters obtained to characterize the rate of improvement, thus allowing a precise monitoring of patient's recovery. A one degree of freedom (DoF) wrist manipulator and a two-DoF elbow-shoulder manipulator were designed using an admittance control strategy; if the patient could not move the handle, the devices completed the motor task. Two groups of chronic post-stroke patients (G1 n=7, and G2 n=9) were enrolled in a three week rehabilitation program including standard physical therapy (45 min daily) plus treatment by means of robot devices, respectively, for wrist and elbow-shoulder movements (40 min, twice daily). Both groups were evaluated by means of standard clinical assessment scales and a new robot measured evaluation metrics that included an active movement index quantifying the patient's ability to execute the assigned motor task without robot assistance, the mean velocity, and a movement accuracy index measuring the distance of the executed path from the theoretic one. After treatment, both groups improved their motor deficit and disability. In G1, there was a significant change in the clinical scale values (p<0.05) and range of motion wrist extension (p<0.02). G2 showed a significant change in clinical scales (p<0.01), in strength (p<0.05) and in the robot measured parameters (p<0.01). The relationship between robot measured parameters and the clinical assessment scales showed a moderate and significant correlation (r>0.53 p<0.03). Our findings suggest that robot-aided neurorehabilitation may improve the motor outcome and disability of chronic post-stroke patients. The new robot measured parameters may provide useful information about the course of treatment and its effectiveness at discharge.

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Neural Systems and Rehabilitation Engineering, IEEE Transactions on  (Volume:13 ,  Issue: 3 )