An investigation on robot-based therapies for whole-arm neurorehabilitation following a stroke

• Main Author: Loureiro, Rui Carlos Vicente
• Published: University of Reading 2009
• Subjects: 616.8103
• Online Access: http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.502496

Strokes affect thousands of people worldwide leaving sufferers with severe disabilities affecting their daily activities. Lesions to one part of the sensory or motor cortex produces symptoms in the opposite half of the body. Lesions might also impair speech, cognition and movement. Evidence supports the use of robot-mediated therapy to reduce functional upper limb impairment but current technologies only target proximal or distal upper limb segments independently. This study developed and evaluated whole-arm robot-aided rehabilitation, using a purpose designed robotic system for upper limb rehabilitation facilitating selective functional reaching and grasping movements in a reach-grasp-transport-release sequence with a task orientated paradigm incorporating visual, audio, haptic and performance feedback. A clinical trial with a total duration of twelve weeks was conducted with four stroke impaired subjects at the sub-acute phase of recovery and with four unimpaired volunteers. Impaired subjects were exposed to sixteen hours of robotic intervention whereas the unimpaired participants experienced one hour of robotic therapy. Clinical outcome measures were used to assess therapy effectiveness on the recovery of the stroke participants prior to the study, during the study and on study completion. Electromyography techniques were used to quantify functional gains obtained with the clinical outcome measures and features from two muscles on the hand involved in grasp and release movements. The results obtained from the clinical outcome measures showed substantial gains in favour of the robot-aided intervention. The clinical outcome results are consistent with the results reported in the literature, and show higher gains when compared to other sub-acute studies targeting only proximal arm segments. Specific muscle features were indentified with the unimpaired participants reproduced with the stroke subjects at the end of the robot-aided intervention.