Robotic technologies and rehabilitation: new tools for upper-limb therapy and assessment in chronic stroke.

BACKGROUND The use of robotic technology for assessment has the potential to provide therapists with objective, accurate, repeatable measurements of subject's functions. However, despite the increasing number of clinical studies examining the effect of robotic training on stroke rehabilitation, body functions and structures assessment is typically carried out through traditional human-administered clinical impairment scales. AIM The paper aims at providing a complete set of kinematic and dynamic indices for an objective measure of the effect of robot-aided therapy, and testing their correlation with clinical scales. DESIGN An intervention pilot study applying robotic therapy was carried out. SETTING The clinical study was focused on outpatients and was carried out at Università Campus Bio-Medico of Rome, Italy. POPULATION Fifteen community-dwelling persons with chronic stroke met inclusion criteria and volunteered to participate. METHODS Upper limb robotic therapy was administered to patients. Kinematic and dynamic performance indices were extracted from position and force data recorded with the InMotion2 robot. A linear regression analysis was carried out to study correlation with clinical scales to extract a core set of performance indicators. RESULTS Robotic outcome measures showed a significant improvement of kinematic motor performance; the improvement of dynamic components was significant only in resistive motion and highly correlated with Motor Power. CONCLUSION Preliminary results showed that arm motor functions and strength of the paretic arm can be objectively measured by means of the proposed bunch of robotic measures. Correlation with Motor Power was high, while correlation with Fugl-Meyer was moderate. CLINICAL REHABILITATION IMPACT An improvement of clinical body functions assessment is expected in terms of objective, accurate and repeatable measurements of subject's performance during recovery.