Federica Tamburella1,2, Juan C Moreno3, Marco Iosa4, Iolanda Pisotta2, Febo Cincotti5,6, Donatella Mattia6, José L Pons3, Marco Molinari2. 1. a SPInal REhabilitation Lab and Laboratory (SPIRE Lab.), Neurorehabilitation1 - Spinal Center , IRCCS S. Lucia Foundation , Rome , Italy. 2. b Laboratory of Robotics Applied to Neurological Rehabilitation, (NeuroRobot Lab.), Neurorehabilitation1 - Spinal Center , IRCCS S. Lucia Foundation , Rome , Italy. 3. c Spanish National Research Council, Cajal Institute, Neural Rehabilitation Group , Madrid , Spain. 4. d Clinical Laboratory of Experimental Neurorehabilitation , IRCCS S. Lucia Foundation , Rome , Italy. 5. e Department of Computer, Control and Management Engineering , Sapienza University of Rome , Rome , Italy. 6. f Neuroelectrical Imaging and BCI Lab , IRCCS S. Lucia Foundation , Rome , Italy.
Abstract
BACKGROUND:Spasticity is a motor disorder that is commonly treated manually by a physical therapist (PhT) stretching the muscles. Recent data on learning have demonstrated the importance of human-to-human interaction in improving rehabilitation: cooperative motor behavior engages specific areas of the motor system compared with execution of a task alone. OBJECTIVES: We hypothesize that PhT-guided therapy that involves active collaboration with the patient (Pt) through shared biomechanical visual biofeedback (vBFB) positively impacts learning and performance by the Pt during ankle spasticity treatment. A sensorized ankle foot orthosis (AFO) was developed to provide online quantitative data of joint range of motion (ROM), angular velocity, and electromyographic activity to the PhT and Pt during the treatment of ankle spasticity. METHODS: Randomized controlled clinical trial. Ten subacute stroke inpatients, randomized into experimental (EXP) and control (CTRL) groups, underwent six weeks of daily treatment. The EXP group was treated with an active AFO, and the CTRL group was given an inactive AFO. Spasticity, ankle ROM, ankle active and passive joint speed, and coactivation index (CI) were assessed at enrollment and after 15-30 sessions. RESULTS:Spasticity and CI (p < 0.005) decreased significantly after training only in the EXP group, in association with a significant rise in active joint speed and active ROM (p < 0.05). Improvements in spasticity (p < 0.05), active joint speed (p < 0.001), and CI (p < 0.001) after treatment differed between the EXP and CTRL groups. CONCLUSIONS: PhT-Pt sharing of exercise information, provided by joint sensorization and vBFB, improved the efficacy of the conventional approach for treating ankle spasticity in subacute stroke Pts.
RCT Entities:
BACKGROUND:Spasticity is a motor disorder that is commonly treated manually by a physical therapist (PhT) stretching the muscles. Recent data on learning have demonstrated the importance of human-to-human interaction in improving rehabilitation: cooperative motor behavior engages specific areas of the motor system compared with execution of a task alone. OBJECTIVES: We hypothesize that PhT-guided therapy that involves active collaboration with the patient (Pt) through shared biomechanical visual biofeedback (vBFB) positively impacts learning and performance by the Pt during ankle spasticity treatment. A sensorized ankle foot orthosis (AFO) was developed to provide online quantitative data of joint range of motion (ROM), angular velocity, and electromyographic activity to the PhT and Pt during the treatment of ankle spasticity. METHODS: Randomized controlled clinical trial. Ten subacute stroke inpatients, randomized into experimental (EXP) and control (CTRL) groups, underwent six weeks of daily treatment. The EXP group was treated with an active AFO, and the CTRL group was given an inactive AFO. Spasticity, ankle ROM, ankle active and passive joint speed, and coactivation index (CI) were assessed at enrollment and after 15-30 sessions. RESULTS:Spasticity and CI (p < 0.005) decreased significantly after training only in the EXP group, in association with a significant rise in active joint speed and active ROM (p < 0.05). Improvements in spasticity (p < 0.05), active joint speed (p < 0.001), and CI (p < 0.001) after treatment differed between the EXP and CTRL groups. CONCLUSIONS: PhT-Pt sharing of exercise information, provided by joint sensorization and vBFB, improved the efficacy of the conventional approach for treating ankle spasticity in subacute stroke Pts.
Authors: Marios Spanakis; Ioanna Xylouri; Evridiki Patelarou; Athina Patelarou Journal: Int J Environ Res Public Health Date: 2022-07-28 Impact factor: 4.614