Article

Robotic neurorehabilitation, thanks to high dosage/intensity training
protocols, has the potential for a greater impact on impairment. OBJECTIVE: We
aimed to analyze how time since the acute event may influence the motor recovery
process during robot-assisted rehabilitation of the upper limb. METHODS: A total
of 41 patients after stroke were enrolled: 20 in subacute phase, i.e. </= 6
months elapsed since their unilateral cerebrovascular accident (CVA), and 21 at
chronic stage, i.e. > 6 months since CVA. All subjects underwent 30 minutes of
robot-aided rehabilitation twice a day, 5 days a week for at least three weeks of
training. Patients were evaluated at the start and end of treatment using the
Fugl-Meyer and Modified Ashworth clinical scales and by a set of robot measured
kinematic parameters. The time interval from stroke was considered as a grouping
factor to analyze its impact on time course of recovery. RESULTS: After training
both groups significantly improved their impairment (F = 44.25, p < 0.001) but
sub-acute patients showed a greater improvement on the Fugl-Meyer scale than
chronic patients. The time course of recovery of the kinematic variables showed
higher time constants of motor improvement in the sub-acute than chronic group,
but they were one order lower than spontaneous recovery time constants.
CONCLUSIONS: Spontaneous recovery seems to have a limited impact on the
improvement of sub-acute patients, most of their changes being likely due to
re-learning during rehabilitation. In addition, a longer recovery time was
required to maximize outcome in sub-acute than in chronic patients.

Langue : ANGLAIS