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Gnasso R, Palermi S, Picone A, Tarantino D, Fusco G, Messina MM, Sirico F. Robotic-Assisted Rehabilitation for Post-Stroke Shoulder Pain: A Systematic Review. SENSORS (BASEL, SWITZERLAND) 2023; 23:8239. [PMID: 37837068 PMCID: PMC10575254 DOI: 10.3390/s23198239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 09/27/2023] [Accepted: 10/02/2023] [Indexed: 10/15/2023]
Abstract
Post-stroke shoulder pain (PSSP) is a debilitating consequence of hemiplegia, often hindering rehabilitation efforts and further limiting motor recovery. With the advent of robotic-assisted therapies in neurorehabilitation, there is potential for innovative interventions for PSSP. This study systematically reviewed the current literature to determine the effectiveness of robotic-assisted rehabilitation in addressing PSSP in stroke patients. A comprehensive search of databases was conducted, targeting articles published up to August 2023. Studies were included if they investigated the impact of robotic-assisted rehabilitation on PSSP. The outcome of interest was pain reduction. The risk of bias was assessed using the Cochrane database. Of the 187 initially identified articles, 3 studies met the inclusion criteria, encompassing 174 patients. The reviewed studies indicated a potential benefit of robotic-assisted rehabilitation in reducing PSSP, with some studies also noting improvements in the range of motion and overall motor function. However, the results varied across studies, with some showing more significant benefits than others, because these use different protocols and robotic equipment.
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Affiliation(s)
| | - Stefano Palermi
- Public Health Department, University of Napoli “Federico II”, Via Pansini 5, 80131 Naples, Italy; (R.G.); (A.P.); (D.T.); (G.F.); (M.M.M.); (F.S.)
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Evaluation of an upper limb robotic rehabilitation program on motor functions, quality of life, cognition, and emotional status in patients with stroke: a randomized controlled study. Neurol Sci 2022; 43:1177-1188. [PMID: 34247295 DOI: 10.1007/s10072-021-05431-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 06/24/2021] [Indexed: 12/21/2022]
Abstract
OBJECTIVE This study aims to find out whether including robotic therapy in addition to a conventional rehabilitation program affects the quality of life, motor function, cognition, and emotional status of hemiplegic patients. DESIGN Thirty-seven stroke patients recruited between April 2016 and April 2019 were included in the study. The patients were randomized into 2 groups (Robotic rehabilitation group-RR n:17, Control group n:20), RR was arranged to be 30-45 min, 5 days per week for 4 weeks. All patients were assessed at the beginning of therapy and the end of 4th week with Brunnstrom stages of motor recovery, Fugl-Meyer Assessment (FMA), handgrip strength, Purdue peg test, Minnesota manual dexterity test, Modified Ashworth Scale (MAS), Functional Independence Measure (FIM), Stroke Specific Quality of Life Scale (SS-QOL), Nottingham Extended Activities of Daily Living (NEADL) Scale, Montreal Cognitive Assessment (MoCA) and Center for Epidemiological Studies Depression Scale (CES- D). RESULTS Improvements in motor function scores, spasticity, general functioning, activities of daily living, cognitive assessment were better in the robotic group when compared to the control group but this difference was not statistically significant (p > 0.05). Improvement in the CES-D in the RR-group was better in comparison to the control group (p = 0.018). CONCLUSION Improvements in motor functions were observed after the treatment in both groups. Although RR group improved better in numbers, none of the outcomes except the CES-D scale were significant. Robotic rehabilitation provides a favorable alternative bringing slight benefits, and also is advantageous in terms of work power and psychological recovery, making its addition to conventional neurological rehabilitation effective and useful in patient management after stroke. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT04393480.
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A Parallel Robot with Torque Monitoring for Brachial Monoparesis Rehabilitation Tasks. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11219932] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Robots for rehabilitation tasks require a high degree of safety for the interaction with both the patients and for the operators. In particular, high safety is a stable and intuitive control of the moving elements of the system combined with an external system of sensors able to monitor the position of every aspect of the rehabilitation system (operator, robot, and patient) and overcome in a certain measure all the events that may occur during the robotic rehabilitation procedure. This paper presents the development of an internal torque monitoring system for ASPIRE. This is a parallel robot designed for shoulder rehabilitation, which enables the use of strategies towards developing a HRI (human–robot interaction) system for the therapy. A complete analysis regarding the components of the robotic system is carried out with the purpose of determining the dynamic behavior of the system. Next, the proposed torque monitoring system is developed with respect to the previously obtained data. Several experimental tests are performed using healthy subjects being equipped with a series of biomedical sensors with the purpose of validating the proposed torque monitoring strategy and, at the same time, to satisfy the degree of safety that is requested by the medical procedure.
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Major ZZ, Vaida C, Major KA, Tucan P, Brusturean E, Gherman B, Birlescu I, Craciunaș R, Ulinici I, Simori G, Banica A, Pop N, Burz A, Carbone G, Pisla D. Comparative Assessment of Robotic versus Classical Physical Therapy Using Muscle Strength and Ranges of Motion Testing in Neurological Diseases. J Pers Med 2021; 11:jpm11100953. [PMID: 34683094 PMCID: PMC8541455 DOI: 10.3390/jpm11100953] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 09/20/2021] [Accepted: 09/22/2021] [Indexed: 01/02/2023] Open
Abstract
The use of robotic systems in physical rehabilitation protocols has become increasingly attractive and has been given more focus in the last decade as a result of the high prevalence of motor deficits in the population, which is linked to an overburdened healthcare system. In accordance with current trends, three robotic devices have been designed, called ParReEx Elbow, ParReEx Wrist, and ASPIRE, which were designed to improve upper-limb medical recovery (shoulder, elbow, forearm, and wrist). The three automated systems were tested in a hospital setting with 23 patients (12 men and 11 women) suffering from motor deficits caused by various neurological diseases such as stroke, Parkinson’s disease, and amyotrophic lateral sclerosis (ALS). The patients were divided into three groups based on their pathology (vascular, extrapyramidal, and neuromuscular). Objective clinical measures, such as the Medical Research Council (MRC) scale, goniometry, and dynamometry, were used to compare pre- and post-rehabilitation assessments for both robotic-aided and manual physical rehabilitation therapy. The results of these tests showed that, with the exception of a few minor differences in muscular strength recovery, the robotic-assisted rehabilitation methods performed equally as well as the manual techniques, though only minor improvements were validated during short-term rehabilitation. The greatest achievements were obtained in the goniometric analysis where some rehabilitation amplitudes increased by over 40% in the vascular group, but the same analysis returned regressions in the neuromuscular group. The MRC scale analysis returned no significant differences, with most regressions occurring in the neuromuscular group. The dynamometric analysis mostly returned improvements, but the highest value evolution was 19.07%, which also in the vascular group. While the results were encouraging, more research is needed with a larger sample size and a longer study period in order to provide more information regarding the efficacy of both rehabilitation methods in neurological illnesses.
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Affiliation(s)
- Zoltán Zsigmond Major
- Neurophysiology Department, National Center for Spinal Disorders, Királyhágó u. 1, 1126 Budapest, Hungary;
- Neurology Department, Municipal Clinical Hospital Cluj-Napoca, 400139 Cluj-Napoca, Romania; (E.B.); (R.C.); (G.S.)
| | - Calin Vaida
- Research Center for Industrial Robots Simulation and Testing, Technical University of Cluj-Napoca, 400114 Cluj-Napoca, Romania; (P.T.); (B.G.); (I.B.); (I.U.); (A.B.); (N.P.); (A.B.)
- Correspondence: (C.V.); (D.P.)
| | - Kinga Andrea Major
- Second ICU, Neurosurgery Department, Cluj County Emergency Clinical Hospital, Strada Clinicilor 3-5, 400000 Cluj-Napoca, Romania;
| | - Paul Tucan
- Research Center for Industrial Robots Simulation and Testing, Technical University of Cluj-Napoca, 400114 Cluj-Napoca, Romania; (P.T.); (B.G.); (I.B.); (I.U.); (A.B.); (N.P.); (A.B.)
| | - Emanuela Brusturean
- Neurology Department, Municipal Clinical Hospital Cluj-Napoca, 400139 Cluj-Napoca, Romania; (E.B.); (R.C.); (G.S.)
| | - Bogdan Gherman
- Research Center for Industrial Robots Simulation and Testing, Technical University of Cluj-Napoca, 400114 Cluj-Napoca, Romania; (P.T.); (B.G.); (I.B.); (I.U.); (A.B.); (N.P.); (A.B.)
| | - Iosif Birlescu
- Research Center for Industrial Robots Simulation and Testing, Technical University of Cluj-Napoca, 400114 Cluj-Napoca, Romania; (P.T.); (B.G.); (I.B.); (I.U.); (A.B.); (N.P.); (A.B.)
| | - Raul Craciunaș
- Neurology Department, Municipal Clinical Hospital Cluj-Napoca, 400139 Cluj-Napoca, Romania; (E.B.); (R.C.); (G.S.)
| | - Ionut Ulinici
- Research Center for Industrial Robots Simulation and Testing, Technical University of Cluj-Napoca, 400114 Cluj-Napoca, Romania; (P.T.); (B.G.); (I.B.); (I.U.); (A.B.); (N.P.); (A.B.)
| | - Gábor Simori
- Neurology Department, Municipal Clinical Hospital Cluj-Napoca, 400139 Cluj-Napoca, Romania; (E.B.); (R.C.); (G.S.)
| | - Alexandru Banica
- Research Center for Industrial Robots Simulation and Testing, Technical University of Cluj-Napoca, 400114 Cluj-Napoca, Romania; (P.T.); (B.G.); (I.B.); (I.U.); (A.B.); (N.P.); (A.B.)
| | - Nicoleta Pop
- Research Center for Industrial Robots Simulation and Testing, Technical University of Cluj-Napoca, 400114 Cluj-Napoca, Romania; (P.T.); (B.G.); (I.B.); (I.U.); (A.B.); (N.P.); (A.B.)
| | - Alin Burz
- Research Center for Industrial Robots Simulation and Testing, Technical University of Cluj-Napoca, 400114 Cluj-Napoca, Romania; (P.T.); (B.G.); (I.B.); (I.U.); (A.B.); (N.P.); (A.B.)
| | - Giuseppe Carbone
- DIMEG, University of Calabria, Via Pietro Bucci, 87036 Rende, Italy;
| | - Doina Pisla
- Research Center for Industrial Robots Simulation and Testing, Technical University of Cluj-Napoca, 400114 Cluj-Napoca, Romania; (P.T.); (B.G.); (I.B.); (I.U.); (A.B.); (N.P.); (A.B.)
- Correspondence: (C.V.); (D.P.)
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