Performance-Based Robotic Training in Individuals with Subacute Stroke: Differences between Responders and Non-Responders
The high variability of upper limb motor recovery with robotic training (RT) in subacute stroke underscores the need to explore differences in responses to RT. We explored differences in baseline characteristics and the RT dose between responders (ΔFugl-Meyer Assessment (FMA) score ≥ 9 points; <i...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-04-01
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| Series: | Sensors |
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| Online Access: | https://www.mdpi.com/1424-8220/23/9/4304 |
| _version_ | 1797601709490438144 |
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| author | Ophélie Pila Christophe Duret Typhaine Koeppel Pascal Jamin |
| author_facet | Ophélie Pila Christophe Duret Typhaine Koeppel Pascal Jamin |
| author_sort | Ophélie Pila |
| collection | DOAJ |
| description | The high variability of upper limb motor recovery with robotic training (RT) in subacute stroke underscores the need to explore differences in responses to RT. We explored differences in baseline characteristics and the RT dose between responders (ΔFugl-Meyer Assessment (FMA) score ≥ 9 points; <i>n</i> = 20) and non-responders (<i>n</i> = 16) in people with subacute stroke (mean [SD] poststroke time at baseline, 54 (26) days, baseline FMA score, 23 (17) points) who underwent 16 RT sessions combined with conventional therapies. Baseline characteristics were compared between groups. During RT sessions, the actual practice time (%), number of movements performed, and total distance covered (cm) in assisted and unassisted modalities were compared between groups. At baseline, participant characteristics and FMA scores did not differ between groups. During the RT, non-responders increased practice time (+15%; <i>p</i> = 0.02), performed more movements (+285; <i>p</i> = 0.004), and covered more distance (+4037 cm; <i>p</i> < 10<sup>−3</sup>), with no difference between physical modalities. In contrast, responders decreased practice time (−21%; <i>p</i> = 0.01) and performed fewer movements (−338; <i>p</i> = 0.03) in the assisted modality while performing more movements (+328; <i>p</i> < 0.05) and covering a greater distance (+4779 cm; <i>p</i> = 0.01) in unassisted modalities. Despite a large amount of motor practice, motor outcomes did not improve in non-responders compared to responders: the difficulty level in RT may have been too low for them. Future studies should combine robot-based parameters to describe the treatment dose, especially in people with severe-to-moderate arm paresis, to optimize the RT and improve the recovery prognosis. |
| first_indexed | 2024-03-11T04:06:28Z |
| format | Article |
| id | doaj.art-007033bc66c84a8793e5b97ebd80b82e |
| institution | Directory Open Access Journal |
| issn | 1424-8220 |
| language | English |
| last_indexed | 2024-03-11T04:06:28Z |
| publishDate | 2023-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Sensors |
| spelling | doaj.art-007033bc66c84a8793e5b97ebd80b82e2023-11-17T23:42:32ZengMDPI AGSensors1424-82202023-04-01239430410.3390/s23094304Performance-Based Robotic Training in Individuals with Subacute Stroke: Differences between Responders and Non-RespondersOphélie Pila0Christophe Duret1Typhaine Koeppel2Pascal Jamin3Centre de Rééducation Fonctionnelle Les Trois Soleils, Médecine Physique et de Réadaptation, Unité de Neurorééducation, 77310 Boissise-Le-Roi, FranceCentre de Rééducation Fonctionnelle Les Trois Soleils, Médecine Physique et de Réadaptation, Unité de Neurorééducation, 77310 Boissise-Le-Roi, FranceCentre de Rééducation Fonctionnelle Les Trois Soleils, Médecine Physique et de Réadaptation, Unité de Neurorééducation, 77310 Boissise-Le-Roi, FranceInstitut Robert Merle d’Aubigné, Rééducation et Appareillage, 94460 Valenton, FranceThe high variability of upper limb motor recovery with robotic training (RT) in subacute stroke underscores the need to explore differences in responses to RT. We explored differences in baseline characteristics and the RT dose between responders (ΔFugl-Meyer Assessment (FMA) score ≥ 9 points; <i>n</i> = 20) and non-responders (<i>n</i> = 16) in people with subacute stroke (mean [SD] poststroke time at baseline, 54 (26) days, baseline FMA score, 23 (17) points) who underwent 16 RT sessions combined with conventional therapies. Baseline characteristics were compared between groups. During RT sessions, the actual practice time (%), number of movements performed, and total distance covered (cm) in assisted and unassisted modalities were compared between groups. At baseline, participant characteristics and FMA scores did not differ between groups. During the RT, non-responders increased practice time (+15%; <i>p</i> = 0.02), performed more movements (+285; <i>p</i> = 0.004), and covered more distance (+4037 cm; <i>p</i> < 10<sup>−3</sup>), with no difference between physical modalities. In contrast, responders decreased practice time (−21%; <i>p</i> = 0.01) and performed fewer movements (−338; <i>p</i> = 0.03) in the assisted modality while performing more movements (+328; <i>p</i> < 0.05) and covering a greater distance (+4779 cm; <i>p</i> = 0.01) in unassisted modalities. Despite a large amount of motor practice, motor outcomes did not improve in non-responders compared to responders: the difficulty level in RT may have been too low for them. Future studies should combine robot-based parameters to describe the treatment dose, especially in people with severe-to-moderate arm paresis, to optimize the RT and improve the recovery prognosis.https://www.mdpi.com/1424-8220/23/9/4304responsivenesshemiparesisupper extremitykinematicsrobot-based therapytraining modality |
| spellingShingle | Ophélie Pila Christophe Duret Typhaine Koeppel Pascal Jamin Performance-Based Robotic Training in Individuals with Subacute Stroke: Differences between Responders and Non-Responders Sensors responsiveness hemiparesis upper extremity kinematics robot-based therapy training modality |
| title | Performance-Based Robotic Training in Individuals with Subacute Stroke: Differences between Responders and Non-Responders |
| title_full | Performance-Based Robotic Training in Individuals with Subacute Stroke: Differences between Responders and Non-Responders |
| title_fullStr | Performance-Based Robotic Training in Individuals with Subacute Stroke: Differences between Responders and Non-Responders |
| title_full_unstemmed | Performance-Based Robotic Training in Individuals with Subacute Stroke: Differences between Responders and Non-Responders |
| title_short | Performance-Based Robotic Training in Individuals with Subacute Stroke: Differences between Responders and Non-Responders |
| title_sort | performance based robotic training in individuals with subacute stroke differences between responders and non responders |
| topic | responsiveness hemiparesis upper extremity kinematics robot-based therapy training modality |
| url | https://www.mdpi.com/1424-8220/23/9/4304 |
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