WHERE THE FUCK IS THE PROTOCOL FOR THIS LOCATED? So survivors can bring it to their therapists for recovery. Top down does not work, as proven by how fucking out-of-date your stroke medical professionals are. Proven by asking when the last rehab protocol was implemented in their hospital. Notice the email address and phone for your doctor to completely prove incompetence by DOING NOTHING!
Effects of proximal and distal robot-assisted upper limb rehabilitation on chronic stroke recovery
Stefano Mazzoleni a,b,∗,
Patrizio Sale c,
Marco Franceschini c,
Samuele Bigazzi d,
Maria ChiaraCarrozza a,b,
Paolo Dario a,b
and Federico Posteraro b,d
and Federico Posteraro b,d
a The BioRobotics Institute, Scuola Superiore Sant’Anna, Pisa, Italy
b Bioengineering Rehabilitation Laboratory, Volterra, Italy
c IRCCS San Raffaele Pisana, Roma, Italy
d Neurological Rehabilitation and Brain Injury Unit, Auxilium Vitae Rehabilitation Center, Volterra, Italy
OBJECTIVE:
To evaluate the effects of add-on distal upper limb robot-assisted treatment on the outcome of proximal regions.
DESIGN:
64 chronic stroke patients divided into two groups participated in the study. Group A was assigned to the proximal robot assisted rehabilitation,GroupB to the proximal and distal. Shoulder/elbow subsection of Fugl-Meyer Assessment scale was collected for Group A, whereas for Group B wrist subsection was also collected. Motricity Index was used and a set of kinematic parameters was computed for both groups.
RESULTS:
A decrease in impairment after the treatment in both groups of patients (Group A: Shoulder/elbow FM
p<0.001 andMI p<0.001;GroupB:Shoulder/elbowFM p<0.001andMI p<0.001) was found. In the GroupB wrist subsection of FM showed an improvement as well (p<0.001). No difference between groups was found in changes of clinical scales. Movement velocity and accuracy increased after the robot-assisted treatment in both groups; group B showed a greater improvement in velocity.
CONCLUSIONS:
Robotic treatment is effective to reduce motor impairment in chronic stroke patients even if distal training added to proximal segments in the Group B does not provide any incremental benefit to the proximal segments. It remains unclear if the effectiveness of robot-assisted treatment is directly related to the upper limb segment specifically treated and which order may lead to better outcome.Our study suggests that kinematic parameters should be computed in order to better clarify the role of distal training (wrist) on proximal segments (shoulder/elbow) as well.Keywords: Rehabilitation, robotics, stroke, upper limb, assessment
∗
Address for correspondence: Stepano Mazzoleni, The BioRobo-tics Institute, Scuola Superiore Sant’Anna, Polo Sant’Anna Valdera,Viale R. Piaggio, 34 - 56025 Pontedera (Pisa) – Italy and Rehabil-itation Bioengineering Laboratory, Borgo San Lazzaro, 5 – 56048Volterra (Pisa) - Italy. Tel.: +39 050883132; Fax: +39 050883101;E-mail: s.mazzoleni@sssup.it.
b Bioengineering Rehabilitation Laboratory, Volterra, Italy
c IRCCS San Raffaele Pisana, Roma, Italy
d Neurological Rehabilitation and Brain Injury Unit, Auxilium Vitae Rehabilitation Center, Volterra, Italy
Abstract
.OBJECTIVE:
To evaluate the effects of add-on distal upper limb robot-assisted treatment on the outcome of proximal regions.
DESIGN:
64 chronic stroke patients divided into two groups participated in the study. Group A was assigned to the proximal robot assisted rehabilitation,GroupB to the proximal and distal. Shoulder/elbow subsection of Fugl-Meyer Assessment scale was collected for Group A, whereas for Group B wrist subsection was also collected. Motricity Index was used and a set of kinematic parameters was computed for both groups.
RESULTS:
A decrease in impairment after the treatment in both groups of patients (Group A: Shoulder/elbow FM
p<0.001 andMI p<0.001;GroupB:Shoulder/elbowFM p<0.001andMI p<0.001) was found. In the GroupB wrist subsection of FM showed an improvement as well (p<0.001). No difference between groups was found in changes of clinical scales. Movement velocity and accuracy increased after the robot-assisted treatment in both groups; group B showed a greater improvement in velocity.
CONCLUSIONS:
Robotic treatment is effective to reduce motor impairment in chronic stroke patients even if distal training added to proximal segments in the Group B does not provide any incremental benefit to the proximal segments. It remains unclear if the effectiveness of robot-assisted treatment is directly related to the upper limb segment specifically treated and which order may lead to better outcome.Our study suggests that kinematic parameters should be computed in order to better clarify the role of distal training (wrist) on proximal segments (shoulder/elbow) as well.Keywords: Rehabilitation, robotics, stroke, upper limb, assessment
∗
Address for correspondence: Stepano Mazzoleni, The BioRobo-tics Institute, Scuola Superiore Sant’Anna, Polo Sant’Anna Valdera,Viale R. Piaggio, 34 - 56025 Pontedera (Pisa) – Italy and Rehabil-itation Bioengineering Laboratory, Borgo San Lazzaro, 5 – 56048Volterra (Pisa) - Italy. Tel.: +39 050883132; Fax: +39 050883101;E-mail: s.mazzoleni@sssup.it.
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