Whole-arm stroke rehabilitation using an interactive sensorimotor robotic environment in combination conventional therapies enhances upper limb movement recovery

Introduction: In recent years new rehabilitation techniques have emerged such as constraint-induced therapy, biofeedback therapy and robot-aided therapy, as alternatives to conventional physical therapies. Robotic techniques allow precise recording of movements and application of forces to the affected limb, making it a valuable tool for motor rehabilitation. In addition, robot-aided therapy can utilise visual cues conveyed on a computer screen to convert repetitive movement practice into an engaging task such as a game. This paper presents the development and evaluation of whole-arm robot-aided therapy, 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-oriented paradigm incorporating visual, audio, haptic and performance feedback. Method: A clinical pilot study with a total duration of twelve weeks was conducted with four stroke impaired subjects at the sub-acute phase of recovery. Subjects were exposed to sixteen hours of robotic intervention. 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. Results: The results obtained from the clinical outcome measures showed substantial gains in favour of the robot-aided intervention. The clinical outcome results show higher gains when compared to other robotic sub-acute studies targeting only proximal arm segments. Conclusion: The study demonstrated the feasibility and potential of reach and grasp therapy for stroke neurorehabilitation in the treatment of patients with upper limb hemiplegia and is a good indicator that this strategy should be pursued.

Special Issue: Abstracts of the 4th UK Forum Stroke Conference, 1-3 December 2009, Glasgow, UK.