Deans' stroke musings: End-effector or exoskeleton in finger-hand stroke rehabilitation: Which is the best choice?

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Saturday, November 20, 2021

End-effector or exoskeleton in finger-hand stroke rehabilitation: Which is the best choice?

Had to look up end effector devices and still don't understand.

End-effector or exoskeleton in finger-hand stroke rehabilitation: Which is the best choice?

L. Moggio1 , N. Marotta1 , A. Demeco1 , C. Marinaro1 , A. Petraroli1 , I. Pino1 , R.C. Meliado’2 , L. Fratto2 , A. Ammendolia1,2 1 Department of Surgical and Medical Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy, 2 A.O.U. Mater Domini, Catanzaro, Italy

Background and Aims:

A new proposal for treating stroke outcomes is robot-assisted therapy. Gassert and Dietz classified upper limb rehabilitation robots into end effectors (EE) and exoskeletons (EXO). This study aimed to compare the relative effects of EE and EXO devices in motor recovery and disability and its impact on the quality of life of patients with finger-hand motor impairment post-stroke.

Methods:

We conducted a search to select randomized controlled trials (RCTs) on PubMed, Embase, MEDLINE, the Cochrane library. We considered as outcomes: motility index (MI), quick version of the arm, shoulder and hand disability questionnaire (QuickDASH) and evaluation Fugl-Meyer for the upper extremity (FMAUE). To compare efficacy, we performed a network meta-analysis and a surface under cumulative ranking analysis (SUCRA).

Results:

Five RTCs and 149 subjects were included. A significant decrease in QuickDASH (p <0.05) was observed in the EXO group (ES: -6.71; CI: -9.17, -4.25). FMAUE showed a significant increase (p <0.05) in the EE group (ES: 3; CI: 1.97, 4.04). The SUCRA analysis of MI demonstrated that robotic rehabilitation is more likely to be the best alternative for motor recovery (97.3% EXO probability; 48.3% EE; 4.4% control).

Conclusions:

EXO devices appear to be a better option than EE devices in the treatment of finger-hand motor disability associated with traditional rehabilitation, with important implications in hand motor recovery and reduction of disability. More research is needed focusing on direct comparison of the two devices.