Deans' stroke musings: Robot-assisted upper limb training combined with Botulinum toxin injection in the treatment of upper limb spasticity: a randomised single-blinded controlled trial

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, August 6, 2022

Robot-assisted upper limb training combined with Botulinum toxin injection in the treatment of upper limb spasticity: a randomised single-blinded controlled trial

Does your doctor have enough functioning brain cells to apply this for stroke patients?

Robot-assisted upper limb training combined with Botulinum toxin injection in the treatment of upper limb spasticity: a randomised single-blinded controlled trial

Marialuisa Gandolfi¹^*,

Nicola Valè¹,

Eleonora Kirilova Dimitrova¹,

Stefano Mazzoleni²,

Elena Battini²,

Maria Donata Benedetti¹,

Alberto Gajofatto¹,

Francesco Ferraro³,

Matteo Castelli⁴,

Maruo Camin⁴,

Mirko Filippetti¹,

Carola De Paoli¹,

Elena Chemello¹,

Alessandro Picelli^1,5,

Jessica Corradi¹,

Andreas Waldner⁶,

Leopold Saltuari^7,8 and

Nicola Smania^1,5

¹Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
²The BioRobotics Institute, Scuola Superiore Sant' Anna, Polo Sant' Anna Valdera, Pontedera, Italy
³Section of Neuromotor Rehabilitation, Department of Neuroscience, ASST Carlo Poma, Mantova, Italy
⁴Centro di riabilitazione Franca Martini—ATSM ONLUS, Trento, Italy
⁵UOC Neurorehabilitation, AOUI Verona, Verona, Italy
⁶Department of Neurological Rehabilitation, Private Hospital Villa Melitta, Bolzano, Italy
⁷Research Department for Neurorehabilitation South Tyrol, Bolzano, Italy
⁸Department of Neurology, Hochzirl Hospital, Zirl, Austria

Background : Integration of robotics and upper limb rehabilitation in people with multiple sclerosis (PwMS) has rarely been investigated.

Objective: To compare the effects of robot-assisted hand training against non-robotic hand training on upper limb activity in PwMS. To compare the training effects on hand dexterity, muscle activity, and upper limb dysfunction as measured with the International Classification of Functioning.

Methods: This single-blind, randomized, controlled trial involved 44 PwMS (Expanded Disability Status Scale:1.5–8) and hand dexterity deficits. The experimental group (n = 23) received robot-assisted hand training; the control group (n = 21) received non-robotic hand training. Training protocols lasted for 5 weeks (50 min/session, 2 sessions/week). Before (T0), after (T1), and at 1 month follow-up (T2), a blinded rater evaluated patients using a comprehensive test battery. Primary outcome: Action Research Arm Test. Secondary outcomes: Nine Holes Peg Test; Fugl-Meyer Assessment Scale–upper extremity section; Motricity Index; Motor Activity Log; Multiple Sclerosis (MS) Quality of Life−54; Life Habits assessment—general short form and surface electromyography.

Results: There were no significant between-group differences in primary and secondary outcomes. Electromyography showed relevant changes providing evidence increased activity in the extensor carpi at T1 and T2.

Conclusion: The training effects on upper limb activity and function were comparable between the two groups. However, robot-assisted training demonstrated remarkable effects on upper limb use and muscle activity. https://clinicaltrials.gov NCT03561155.