A new treatment in the rehabilitation of the paretic upper limb after stroke: the ARAMIS prototype and treatment protocol

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Abstract

Background: In recent years, as part of the rehabilitation of post stroke patients had widespread use of robotic technologies to improve recovery of upper limb. ARAMIS is a concept robot and prototype designed to promote the arms functional interaction in the neurorehabilitation of the paretic upper limb. Two computer-controlled, symmetric and interacting exoskeletons compensate for the inadequate strength and accuracy of the paretic arm and the effect of gravity during rehabilitation. Rehabilitation is possible in 3 different modalities; asynchronous, synchronous, active-assisted.

Objectives: to compare the effectiveness of rehabilitation robotic delivered through a exoskeleton prototype system compared to traditional rehabilitation in motor and functional recovery of the upper limb after stroke.

Methods: case-control study, 52 patients enrolled in the study, 28 cases (female: 8, age: 65 ± 10 yrs.) treated with ARAMIS (Automatic Recovery Arm Motility Integrated System) and 24 controls (female: 11, age: 69 ± 7 yrs.) with conventional rehabilitation.

Motor impairment assessed before and after treatment with Fugl-Meyer scale and Motricity Index, level of disability assessed with the Functional Independence Measure. A questionnaire also assessed the tolerability to therapy robotic.

Results: After 28±4 sessions over a 54±3.6 days period, patients treated by ARAMIS improved at the Fugl-Meyer scale (global score from 43±18 to 73±29 [p<0.00001]), Motricity Index scale (p<0.004) and Functional Independence Measure (p<0.001). A lesser degree of improvement was achieved at the conventional rehabilitation, The Fugl-Meyer global score of the control group improved from 41±13 to 58±16 (P<0.006) and the motor function item from 9.4±4.1 to 14.9±5.8 (p<0.023).

Conclusions: The motor improvement at wrist and hand proved greater than at shoulder and elbow in both patients treated by ARAMIS and controls, but it was significantly greater in ARAMIS-treated patients than in controls. The results indicate a greater efficacy of ARAMIS compared to conventional rehabilitation.

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Authors

Loris Pignolo - RAN - Research in Advanced Neurorehabilitation Istituto S. Anna 88900 - Crotone (Italy)

Lucia L. Lucca

Giuseppina Basta

Sebastiano Serra

Maria E. Pugliese

Walter G. Sannita

Walter G. Sannita

Giuliano Dolce

How to Cite
Pignolo, L., Lucca, L. L., Basta, G., Serra, S., Pugliese, M. E., Sannita, W. G., Sannita, W. G., & Dolce, G. (2016). A new treatment in the rehabilitation of the paretic upper limb after stroke: the ARAMIS prototype and treatment protocol. Annali dell’Istituto Superiore Di Sanità, 52(2), 301-308. Retrieved from https://annali.iss.it/index.php/anna/article/view/262
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