Literature DB >> 30904771

Does hand robotic rehabilitation improve motor function by rebalancing interhemispheric connectivity after chronic stroke? Encouraging data from a randomised-clinical-trial.

Rocco Salvatore Calabrò1, Maria Accorinti2, Bruno Porcari2, Luigi Carioti2, Laura Ciatto2, Luana Billeri2, Veronica Agata Andronaco2, Franco Galletti3, Serena Filoni4, Antonino Naro2.   

Abstract

OBJECTIVE: The objective of this study was the evaluation of the clinical and neurophysiological effects of intensive robot-assisted hand therapy compared to intensive occupational therapy in the chronic recovery phase after stroke.
METHODS: 50 patients with a first-ever stroke occurred at least six months before, were enrolled and randomised into two groups. The experimental group was provided with the Amadeo™ hand training (AHT), whereas the control group underwent occupational therapist-guided conventional hand training (CHT). Both of the groups received 40 hand training sessions (robotic and conventional, respectively) of 45 min each, 5 times a week, for 8 consecutive weeks. All of the participants underwent a clinical and electrophysiological assessment (task-related coherence, TRCoh, and short-latency afferent inhibition, SAI) at baseline and after the completion of the training.
RESULTS: The AHT group presented improvements in both of the primary outcomes (Fugl-Meyer Assessment for of Upper Extremity and the Nine-Hole Peg Test) greater than CHT (both p < 0.001). These results were paralleled by a larger increase in the frontoparietal TRCoh in the AHT than in the CHT group (p < 0.001) and a greater rebalance between the SAI of both the hemispheres (p < 0.001).
CONCLUSIONS: These data suggest a wider remodelling of sensorimotor plasticity and interhemispheric inhibition between sensorimotor cortices in the AHT compared to the CHT group. SIGNIFICANCE: These results provide neurophysiological support for the therapeutic impact of intensive robot-assisted treatment on hand function recovery in individuals with chronic stroke.
Copyright © 2019 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.

Entities:  

Keywords:  Amadeo™; Frontoparietal connectivity; Hand rehabilitation; Sensorimotor plasticity

Mesh:

Year:  2019        PMID: 30904771     DOI: 10.1016/j.clinph.2019.02.013

Source DB:  PubMed          Journal:  Clin Neurophysiol        ISSN: 1388-2457            Impact factor:   3.708


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