Potential of motor recovery in upper limb after a 3-month robot assisted therapy in subacute stroke patients

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• 作者：O. Courtial^a ; ^{ophelie.courtial@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; C. Duret ; Dr^a ; F.X. Laborne ; Dr^b ; J.M. Gracies ; Prof^c ; E. Hutin ; Dr^c
• 关键词：Subacute stroke ; Robotic ; Fugl-Meyer ; Kinematic
• 刊名：Annals of Physical and Rehabilitation Medicine
• 出版年：2015
• 出版时间：September 2015
• 年：2015
• 卷：58
• 期：supp_S1
• 页码：e98-e99
• 全文大小：299 K

文摘

Following stroke, the use of robotic in rehabilitation program leads to increase the number of movement performed on each session. The present study aimed to investigate predictive factors of upper limb motor recovery after a 3-month robot-assisted therapy added to conventional occupational therapy.

Methods

In this retrospective study, 22 post-stroke patients (9 women, 53 ± 18 y, delay post-stroke at baseline, M2, 63 ± 25 days) performed robot-assisted shoulder/elbow training in subacute phase (InMotion 2.0, 50 ± 17 sessions over 3 months). All participants underwent evaluations before (M2) and after the training (M5) using the clinical score of Fugl-Meyer (FM) and the hand mean velocity (V) measured by the robot in reaching tasks on horizontal plane toward 3 directions (forward, inside and outside). A predictive model of the patient benefit was tested using Receiver Operating Curve analysis (ROC), based on two criteria: an increase of 9 pts in FM [1] and of 0.04 m/s in hand velocity.

Results

At M5, the FM score increased by 28% (m>pm> = 1.2E^−3, t-test) and V by 122% (m>pm> = 1.2E^−7). Concerning the ROC analysis, based on the first criteria, +9 pts of FM score at M5, the probability (AUC) is 0.86 with a 17 pts FM cut-off at M2 (m>pm> = 4.32E^−5) and 0.64 with a 0.02 m/s velocity cut-off at M2 (m>pm> = 2.62E^−2). Based on the second criteria, +0.04 m/s of hand velocity at M5, the probability is 0.93 with a 20 pts FM cut-off (m>pm> = 7.34E^−16), while the velocity cut-off is no significant.

Discussion

The potential functional benefit (+9 pts of the Fugl-Meyer score [1]), associated with a rehabilitation program including robot-assistive training between the 2^nd and the 5^th months after stroke might be predicted from baseline evaluation.