A Robotic System with EMG-Triggered Functional Eletrical Stimulation for Restoring Arm Functions in Stroke Survivors

Autor: Johannes Zajc, Walter Baccinelli, Giancarlo Ferrigno, Margit Gfoehler, Emilia Ambrosini, Constantin Wiesener, Franco Molteni, Maria Bulgheroni, Andreas Augsten, Karsten Krakow, Roberto Ballarati, Thomas Schauer, Micheal Russold, Markus Puchinger, Mauro Rossini, Simona Ferrante, Nancy Immick, Alessandra Pedrocchi, Giulio Gasperini, Mathias Weber, Sebastian Weber
Rok vydání: 2021
Předmět:
Adult
Male
030506 rehabilitation
medicine.medical_specialty
medicine.medical_treatment
Electric Stimulation Therapy
Stimulation
functional electrical stimulation
rehabilitation
law.invention
Upper Extremity
03 medical and health sciences
0302 clinical medicine
Physical medicine and rehabilitation
Randomized controlled trial
law
Activities of Daily Living
Outcome Assessment
Health Care
arm
Humans
Functional electrical stimulation
Medicine
Single-Blind Method
Stroke survivor
Stroke
Aged
Aged
80 and over
Rehabilitation
Electromyography
business.industry
exoskeleton
Stroke Rehabilitation
Recovery of Function
Robotics
General Medicine
Middle Aged
Exoskeleton Device
medicine.disease
Combined Modality Therapy
stroke
Exercise Therapy
Exoskeleton
Robotic systems
randomized controlled trial
Quality of Life
Female
0305 other medical science
business
030217 neurology & neurosurgery
Zdroj: Neurorehabilitation and Neural Repair. 35:334-345
ISSN: 1552-6844
1545-9683
Popis: Background Robotic systems combined with Functional Electrical Stimulation (FES) showed promising results on upper-limb motor recovery after stroke, but adequately-sized randomized controlled trials (RCTs) are still missing. Objective To evaluate whether arm training supported by RETRAINER, a passive exoskeleton integrated with electromyograph-triggered functional electrical stimulation, is superior to advanced conventional therapy (ACT) of equal intensity in the recovery of arm functions, dexterity, strength, activities of daily living, and quality of life after stroke. Methods A single-blind RCT recruiting 72 patients was conducted. Patients, randomly allocated to 2 groups, were trained for 9 weeks, 3 times per week: the experimental group performed task-oriented exercises assisted by RETRAINER for 30 minutes plus ACT (60 minutes), whereas the control group performed only ACT (90 minutes). Patients were assessed before, soon after, and 1 month after the end of the intervention. Outcome measures were as follows: Action Research Arm Test (ARAT), Motricity Index, Motor Activity Log, Box and Blocks Test (BBT), Stroke Specific Quality of Life Scale (SSQoL), and Muscle Research Council. Results All outcomes but SSQoL significantly improved over time in both groups ( P < .001); a significant interaction effect in favor of the experimental group was found for ARAT and BBT. ARAT showed a between-group change of 11.5 points ( P = .010) at the end of the intervention, which increased to 13.6 points 1 month after. Patients considered RETRAINER moderately usable (System Usability Score of 61.5 ± 22.8). Conclusions Hybrid robotic systems, allowing to perform personalized, intensive, and task-oriented training, with an enriched sensory feedback, was superior to ACT in improving arm functions and dexterity after stroke.
Databáze: OpenAIRE
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