A new study shows that robot-assisted therapy of hand function after stroke is as successful in improving upper limb function as conventional therapy. The results by Raffaele Ranzani and Olivier Lambercy from the group of Roger Gassert will help open new avenues in stroke therapy.
Hand function is often impaired after stroke, affecting the execution of daily activities. Robotic devices can complement rehabilitation therapy offered to persons who suffered from a stroke, but they rarely focus on the training of hand sensorimotor function. The primary goal of our study was to evaluate whether robot-assisted therapy of hand function following a neurocognitive approach (i.e., combining motor training with somatosensory and cognitive tasks) produces an equivalent decrease in upper limb motor impairment compared to conventional neurocognitive therapy.
A randomized controlled trial was conducted on subjects with subacute stroke (less than 6 weeks ago) receiving either conventional or robot-assisted neurocognitive hand therapy. Therapy was provided for fifteen 45-minute sessions divided over four weeks, nested within subjects’ standard therapy program. Primary outcome was the change in arm impairment from the beginning of the therapy, as measured by the upper extremity part of the Fugl-Meyer Assessment (FMA-UE), compared between groups using equivalence testing.
Equivalence between robot-assisted and conventional therapy
33 participants with stroke were enrolled. 14 subjects in the robot-assisted and 13 subjects in the conventional therapy group completed the study. At the end of intervention, all subjects showed decreased upper limb impairment and improved sensorimotor function, with increases of >7 points in the FMA-UE. Statistical analyses established equivalence between robot-assisted and conventional neurocognitive therapy.
Neurocognitive robot-assisted therapy of hand function allows for equivalent motor recovery compared to conventional dose-matched neurocognitive therapy when performed during inpatient rehabilitation in the subacute stage. This enables early familiarization of stroke patients with such technologies, realizing a first step towards minimally-supervised robot-assisted therapy in the clinic and also at home after discharge. Such an approach could help increase therapy dose and maintain functional gains over time.
By: Raffaele Ranzani*(1), Olivier Lambercy*(1), Jean-Claude Metzger (1), Antonella Califfi (2), Stefania Regazzi (2), Daria Dinacci (2), Claudio Petrillo (2), Paolo Rossi (2), Fabio M Conti (2), Roger Gassert (1). Affiliation: (1) ETH Zurich, (2) Clinica Hildebrand Centro di Riabilitazione Brissago.
Neurocognitive robot-assisted rehabilitation of hand function: a randomized control trial on motor recovery in subacute stroke. Ranzani R, Lambercy O, Metzger JC, Califfi A, Regazzi S, Dinacci D, Petrillo C, Rossi P, Conti FM, Gassert R.J Neuroeng Rehabil. 2020 Aug 24;17(1):115. Article