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Influence of New Technologies on Post-Stroke Rehabilitation: A Comparison of Armeo Spring to the Kinect System

Background: New technologies to improve post-stroke rehabilitation outcomes are of great interest and have a positive impact on functional, motor, and cognitive recovery. Identifying the most effective rehabilitation intervention is a recognized priority for stroke research and provides an opportuni...

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Autores principales: Adomavičienė, Aušra, Daunoravičienė, Kristina, Kubilius, Raimondas, Varžaitytė, Lina, Raistenskis, Juozas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6524064/
https://www.ncbi.nlm.nih.gov/pubmed/30970655
http://dx.doi.org/10.3390/medicina55040098
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author Adomavičienė, Aušra
Daunoravičienė, Kristina
Kubilius, Raimondas
Varžaitytė, Lina
Raistenskis, Juozas
author_facet Adomavičienė, Aušra
Daunoravičienė, Kristina
Kubilius, Raimondas
Varžaitytė, Lina
Raistenskis, Juozas
author_sort Adomavičienė, Aušra
collection PubMed
description Background: New technologies to improve post-stroke rehabilitation outcomes are of great interest and have a positive impact on functional, motor, and cognitive recovery. Identifying the most effective rehabilitation intervention is a recognized priority for stroke research and provides an opportunity to achieve a more desirable effect. Objective: The objective is to verify the effect of new technologies on motor outcomes of the upper limbs, functional state, and cognitive functions in post-stroke rehabilitation. Methods: Forty two post-stroke patients (8.69 ± 4.27 weeks after stroke onset) were involved in the experimental study during inpatient rehabilitation. Patients were randomly divided into two groups: conventional programs were combined with the Armeo Spring robot-assisted trainer (Armeo group; n = 17) and the Kinect-based system (Kinect group; n = 25). The duration of sessions with the new technological devices was 45 min/day (10 sessions in total). Functional recovery was compared among groups using the Functional Independence Measure (FIM), and upper limbs’ motor function recovery was compared using the Fugl–Meyer Assessment Upper Extremity (FMA-UE), Modified Ashworth Scale (MAS), Hand grip strength (dynamometry), Hand Tapping test (HTT), Box and Block Test (BBT), and kinematic measures (active Range Of Motion (ROM)), while cognitive functions were assessed by the MMSE (Mini-Mental State Examination), ACE-R (Addenbrooke’s Cognitive Examination-Revised), and HAD (Hospital Anxiety and Depression Scale) scores. Results: Functional independence did not show meaningful differences in scores between technologies (p > 0.05), though abilities of self-care were significantly higher after Kinect-based training (p < 0.05). The upper limbs’ kinematics demonstrated higher functional recovery after robot training: decreased muscle tone, improved shoulder and elbow ROMs, hand dexterity, and grip strength (p < 0.05). Besides, virtual reality games involve more arm rotation and performing wider movements. Both new technologies caused an increase in overall global cognitive changes, but visual constructive abilities (attention, memory, visuospatial abilities, and complex commands) were statistically higher after robotic therapy. Furthermore, decreased anxiety level was observed after virtual reality therapy (p < 0.05). Conclusions: Our study displays that even a short-term, two-week training program with new technologies had a positive effect and significantly recovered post-strokes functional level in self-care, upper limb motor ability (dexterity and movements, grip strength, kinematic data), visual constructive abilities (attention, memory, visuospatial abilities, and complex commands) and decreased anxiety level.
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spelling pubmed-65240642019-06-04 Influence of New Technologies on Post-Stroke Rehabilitation: A Comparison of Armeo Spring to the Kinect System Adomavičienė, Aušra Daunoravičienė, Kristina Kubilius, Raimondas Varžaitytė, Lina Raistenskis, Juozas Medicina (Kaunas) Article Background: New technologies to improve post-stroke rehabilitation outcomes are of great interest and have a positive impact on functional, motor, and cognitive recovery. Identifying the most effective rehabilitation intervention is a recognized priority for stroke research and provides an opportunity to achieve a more desirable effect. Objective: The objective is to verify the effect of new technologies on motor outcomes of the upper limbs, functional state, and cognitive functions in post-stroke rehabilitation. Methods: Forty two post-stroke patients (8.69 ± 4.27 weeks after stroke onset) were involved in the experimental study during inpatient rehabilitation. Patients were randomly divided into two groups: conventional programs were combined with the Armeo Spring robot-assisted trainer (Armeo group; n = 17) and the Kinect-based system (Kinect group; n = 25). The duration of sessions with the new technological devices was 45 min/day (10 sessions in total). Functional recovery was compared among groups using the Functional Independence Measure (FIM), and upper limbs’ motor function recovery was compared using the Fugl–Meyer Assessment Upper Extremity (FMA-UE), Modified Ashworth Scale (MAS), Hand grip strength (dynamometry), Hand Tapping test (HTT), Box and Block Test (BBT), and kinematic measures (active Range Of Motion (ROM)), while cognitive functions were assessed by the MMSE (Mini-Mental State Examination), ACE-R (Addenbrooke’s Cognitive Examination-Revised), and HAD (Hospital Anxiety and Depression Scale) scores. Results: Functional independence did not show meaningful differences in scores between technologies (p > 0.05), though abilities of self-care were significantly higher after Kinect-based training (p < 0.05). The upper limbs’ kinematics demonstrated higher functional recovery after robot training: decreased muscle tone, improved shoulder and elbow ROMs, hand dexterity, and grip strength (p < 0.05). Besides, virtual reality games involve more arm rotation and performing wider movements. Both new technologies caused an increase in overall global cognitive changes, but visual constructive abilities (attention, memory, visuospatial abilities, and complex commands) were statistically higher after robotic therapy. Furthermore, decreased anxiety level was observed after virtual reality therapy (p < 0.05). Conclusions: Our study displays that even a short-term, two-week training program with new technologies had a positive effect and significantly recovered post-strokes functional level in self-care, upper limb motor ability (dexterity and movements, grip strength, kinematic data), visual constructive abilities (attention, memory, visuospatial abilities, and complex commands) and decreased anxiety level. MDPI 2019-04-09 /pmc/articles/PMC6524064/ /pubmed/30970655 http://dx.doi.org/10.3390/medicina55040098 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Adomavičienė, Aušra
Daunoravičienė, Kristina
Kubilius, Raimondas
Varžaitytė, Lina
Raistenskis, Juozas
Influence of New Technologies on Post-Stroke Rehabilitation: A Comparison of Armeo Spring to the Kinect System
title Influence of New Technologies on Post-Stroke Rehabilitation: A Comparison of Armeo Spring to the Kinect System
title_full Influence of New Technologies on Post-Stroke Rehabilitation: A Comparison of Armeo Spring to the Kinect System
title_fullStr Influence of New Technologies on Post-Stroke Rehabilitation: A Comparison of Armeo Spring to the Kinect System
title_full_unstemmed Influence of New Technologies on Post-Stroke Rehabilitation: A Comparison of Armeo Spring to the Kinect System
title_short Influence of New Technologies on Post-Stroke Rehabilitation: A Comparison of Armeo Spring to the Kinect System
title_sort influence of new technologies on post-stroke rehabilitation: a comparison of armeo spring to the kinect system
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6524064/
https://www.ncbi.nlm.nih.gov/pubmed/30970655
http://dx.doi.org/10.3390/medicina55040098
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