Development of a System Architecture for Evaluation and Training of Proprioceptive Deficits of the Upper Limb.

Proprioception plays a fundamental role in maintaining posture and executing movement, and the quantitative evaluation of proprioceptive deficits in poststroke patients is important. But currently it is not widely performed due to the complexity of the evaluation tools required for a reliable assessment. The aims of this pilot study were to (a) develop a system architecture for upper limb evaluation and training of proximal and distal sense of position in the horizontal plane and (b) test the system in healthy and pathological subjects.

Comparison of exercise training effect with different robotic devices for upper limb rehabilitation: a retrospective study.

Background: Several robotic devices have been proposed for upper limb rehabilitation, but they differ in terms of application fields and the technical solutions implemented.

Aim: The aim of this study was to compare the effectiveness of three different robotic devices for shoulder-elbow rehabilitation in reducing motor impairment and improving motor performance in post-stroke patients.

Design: Retrospective multi-center study.

Intensive cycle ergometer training improves gait speed and endurance in patients with Parkinson's disease: A comparison with treadmill training.

Purpose: Cycle ergometer training improves gait in the elderly, but its effect in patients with Parkinson's disease (PD) is not completely known.

Methods: Twenty-nine PD inpatients were randomized to treadmill (n = 13, PD-T) or cycle ergometer (n = 16, PD-C) training for 3 weeks, 1 hour/day. Outcome measures were distance travelled during the 6-min walking test (6MWT), spatio-temporal variables of gait assessed by baropodometry, the Timed Up and Go (TUG) duration, the balance score through the Mini-BESTest, and the score of the Unified Parkinson's Disease Rating Scale (UPDRS).

Effects of slow repetitive transcranial magnetic stimulation in patients with corticobasal syndrome.

Corticobasal syndrome is characterized by asymmetric cortical sensorimotor dysfunction and parkinsonism; an altered cortical excitability has been reported. We explored with transcranial magnetic stimulation the motor cortical excitability in corticobasal syndrome, and the effects of slow repetitive transcranial magnetic stimulation. With transcranial magnetic stimulation, we studied two corticobasal syndrome patients.

Test-retest reliability of robotic assessment measures for the evaluation of upper limb recovery.

Rehabilitation robots have built-in technology and sensors that allow accurate measurement of movement kinematics and kinetics, which can be used to derive measures related to upper limb performance and highlight changes in motor behavior due to rehabilitation. This study aimed to assess the test-retest reliability of some robot-measured parameters by analyzing their intra-session and inter-session (day-by-day) variability. The study was carried out in two groups: 31 patients after stroke and 15 healthy subjects.

Taking a lesson from patients' recovery strategies to optimize training during robot-aided rehabilitation.

In robot-assisted neurorehabilitation, matching the task difficulty level to the patient's needs and abilities, both initially and as the relearning process progresses, can enhance the effectiveness of training and improve patients' motivation and outcome. This study presents a Progressive Task Regulation algorithm implemented in a robot for upper limb rehabilitation. It evaluates the patient's performance during training through the computation of robot-measured parameters, and automatically changes the features of the reaching movements, adapting the difficulty level of the motor task to the patient's abilities.

Measuring changes of movement dynamics during robot-aided neurorehabilitation of stroke patients.

The aim of this study was to describe in detail a new method, called normalized force control parameter (nFCP), to measure changes in movement dynamics obtained during robot-aided neurorehabilitation, and to evaluate its ability to estimate the clinical scales. The study was conducted in a group of 18 subjects after chronic stroke who underwent robot therapy of the upper limb. We used two different measures of movement dynamics to assess patients' performance during each session of training: the nFCP and force directional error (FDE), both measuring the directional error of the patient-exerted force applied to the end-effector of the robot device.

Design strategies to improve patient motivation during robot-aided rehabilitation.

Background: Motivation is an important factor in rehabilitation and frequently used as a determinant of rehabilitation outcome. Several factors can influence patient motivation and so improve exercise adherence. This paper presents the design of two robot devices for use in the rehabilitation of upper limb movements, that can motivate patients during the execution of the assigned motor tasks by enhancing the gaming aspects of rehabilitation.

Robotic techniques for upper limb evaluation and rehabilitation of stroke patients.

This paper presents two robot devices for use in the rehabilitation of upper limb movements and reports the quantitative parameters obtained to characterize the rate of improvement, thus allowing a precise monitoring of patient's recovery. A one degree of freedom (DoF) wrist manipulator and a two-DoF elbow-shoulder manipulator were designed using an admittance control strategy; if the patient could not move the handle, the devices completed the motor task. Two groups of chronic post-stroke patients (G1 n = 7, and G2 n = 9) were enrolled in a three week rehabilitation program including standard physical therapy (45 min daily) plus treatment by means of robot devices, respectively, for wrist and elbow-shoulder movements (40 min, twice daily).