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Stefano Mazzoleni , Scuola Superiore Sant'Anna, Pisa and Laboratory of Rehabilitation Bioengineering, Volterra
Luciano Puzzolante , Auxilium Vitae Rehabilitation Center, Volterra
Loredana Zollo , UniversitÓ Campus Bio-Medico, Rome
Paolo Dario , Scuola Superiore Sant'Anna, Pisa
Federico Posteraro , Auxilium Vitae Rehabilitation Center, Volterra and Laboratory of Rehabilitation Bioengineering, Volterra
ABSTRACT
The aim of this article is to propose a methodology for analysing different recovery mechanisms in subacute and chronic patients through evaluation of biomechanical parameters. Twenty-five post-stroke subjects, eight subacute and seventeen chronic, participated in the study. A 2-DoF robotic system was used for upper limb training. Two clinical scales were used for assessment. Forces and velocities at the robot's end-effector during the execution of upper limb planar reaching movements were measured. Clinical outcome measures show a significant decrease in motor impairment after the treatment both in chronic and subacute patients (MSS-SE, p<0.001; FM, p<0.05). Movement velocity increases after the robot-aided treatment in both groups. Mean values of forces exerted by subacute patients are lower than those observed in chronic patients, both at the beginning and at the end of robotic treatment, as in the latter the pathological pattern is already structured. Our results demonstrate that the monitoring of the forces exerted on the end-effector during robot-aided treatment can identify the specific motor recovery mechanisms at different stages. If the pathological pattern is not yet structured, rehabilitative interventions should be addressed toward the use of motor re-learning procedures; on the other hand, if the force analysis shows a strong pathological pattern, mechanisms of compensation should be encouraged.
INDEX TERMS
Assessment, Biorobotics, Robotics, Artificial Intelligence, Computing Methodologies, Rehabilitation, Stroke, Upper limb
CITATION
Stefano Mazzoleni, Luciano Puzzolante, Loredana Zollo, Paolo Dario, Federico Posteraro, "Mechanisms of Motor Recovery in Chronic and Subacute Stroke Patients Following a Robotaided Training", IEEE Transactions on Haptics, , no. 1, pp. 1, PrePrints PrePrints, doi:10.1109/TOH.2013.73
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