Accepted for/Published in: JMIR Rehabilitation and Assistive Technologies
Date Submitted: Jan 12, 2021
Date Accepted: Jan 25, 2022
Robotic Table and Serious Games for Integrative Rehabilitation Early Post-Stroke: Two Case Reports
ABSTRACT
Background:
BrightArm Compact is a new rehabilitation system for upper extremities. It provides bimanual training with gradated gravity loading and mediates interactions with serious games.
Objective:
To design and test a robotic rehabilitation table-based virtual rehabilitation system for training upper extremities early post-stroke.
Methods:
A new robotic rehabilitation table, controllers and adaptive games were developed. Participants underwent 12 experimental sessions in addition to the standard of care. Standardized measures of upper extremity motor impairment and function, depression severity, and cognitive function were administered pre- and post-intervention. Non-standardized measures included game variables and subjective evaluations.
Results:
Two case study participants attained high total arm repetitions per session (504 and 957, respectively), and achieved high grasp and finger extension counts. Training intensity contributed to marked improvements in affected arm shoulder strength (225% and 100%, respectively), grasp strength (27% and 16% increase), 3-finger pinch strength (31% and 15% increase). Shoulder active flexion range increased 17% and 18%, respectively, and elbow active supination was larger by 75% and 58%, respectively. Improvements in motor function were at/above Minimal Clinically Important Difference for Fugl-Meyer Assessment (11 and 10 points), Chedoke Inventory (11 and 14 points) and Upper Extremity Functional Index (19 and 23 points). Cognitive/emotive outcomes were mixed.
Conclusions:
The design of the robotic rehabilitation table was successfully tested on two participants early post-stroke. Results are encouraging. Clinical Trial: ClinicalTrials.gov NCT04252170
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