Unsupervised robot-assisted rehabilitation after stroke: feasibility, effect on therapy dose, and user experience
Abstract Background Unsupervised robot-assisted rehabilitation is a promising approach to increase the dose of therapy after stroke, which may help promote sensorimotor recovery without requiring significant additional resources and manpower. However, the unsupervised use of robotic technologies is...
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| Format: | Article |
| Language: | English |
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BMC
2024-04-01
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| Series: | Journal of NeuroEngineering and Rehabilitation |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12984-024-01347-4 |
| _version_ | 1797209460777680896 |
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| author | Giada Devittori Daria Dinacci Davide Romiti Antonella Califfi Claudio Petrillo Paolo Rossi Raffaele Ranzani Roger Gassert Olivier Lambercy |
| author_facet | Giada Devittori Daria Dinacci Davide Romiti Antonella Califfi Claudio Petrillo Paolo Rossi Raffaele Ranzani Roger Gassert Olivier Lambercy |
| author_sort | Giada Devittori |
| collection | DOAJ |
| description | Abstract Background Unsupervised robot-assisted rehabilitation is a promising approach to increase the dose of therapy after stroke, which may help promote sensorimotor recovery without requiring significant additional resources and manpower. However, the unsupervised use of robotic technologies is not yet a standard, as rehabilitation robots often show low usability or are considered unsafe to be used by patients independently. In this paper we explore the feasibility of unsupervised therapy with an upper limb rehabilitation robot in a clinical setting, evaluate the effect on the overall therapy dose, and assess user experience during unsupervised use of the robot and its usability. Methods Subacute stroke patients underwent a four-week protocol composed of daily 45 min-sessions of robot-assisted therapy. The first week consisted of supervised therapy, where a therapist explained how to interact with the device. The second week was minimally supervised, i.e., the therapist was present but intervened only if needed. After this phase, if participants learnt how to use the device, they proceeded to two weeks of fully unsupervised training. Feasibility, dose of robot-assisted therapy achieved during unsupervised use, user experience, and usability of the device were evaluated. Questionnaires to evaluate usability and user experience were performed after the minimally supervised week and at the end of the study, to evaluate the impact of therapists’ absence. Results Unsupervised robot-assisted therapy was found to be feasible, as 12 out of the 13 recruited participants could progress to unsupervised training. During the two weeks of unsupervised therapy participants on average performed an additional 360 min of robot-assisted rehabilitation. Participants were satisfied with the device usability (mean System Usability Scale scores > 79), and no adverse events or device deficiencies occurred. Conclusions We demonstrated that unsupervised robot-assisted therapy in a clinical setting with an actuated device for the upper limb was feasible and can lead to a meaningful increase in therapy dose. These results support the application of unsupervised robot-assisted therapy as a complement to usual care in clinical settings and pave the way to its application in home settings. Trial registration Registered on 13.05.2020 on clinicaltrials.gov (NCT04388891). |
| first_indexed | 2024-04-24T09:55:03Z |
| format | Article |
| id | doaj.art-1c169db7157b4b4d9db337f48b0fe236 |
| institution | Directory Open Access Journal |
| issn | 1743-0003 |
| language | English |
| last_indexed | 2024-04-24T09:55:03Z |
| publishDate | 2024-04-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of NeuroEngineering and Rehabilitation |
| spelling | doaj.art-1c169db7157b4b4d9db337f48b0fe2362024-04-14T11:09:27ZengBMCJournal of NeuroEngineering and Rehabilitation1743-00032024-04-0121111110.1186/s12984-024-01347-4Unsupervised robot-assisted rehabilitation after stroke: feasibility, effect on therapy dose, and user experienceGiada Devittori0Daria Dinacci1Davide Romiti2Antonella Califfi3Claudio Petrillo4Paolo Rossi5Raffaele Ranzani6Roger Gassert7Olivier Lambercy8Rehabilitation Engineering Laboratory, Department of Health Sciences and TechnologyClinica Hildebrand Centro di riabilitazione BrissagoClinica Hildebrand Centro di riabilitazione BrissagoClinica Hildebrand Centro di riabilitazione BrissagoClinica Hildebrand Centro di riabilitazione BrissagoClinica Hildebrand Centro di riabilitazione BrissagoRehabilitation Engineering Laboratory, Department of Health Sciences and TechnologyRehabilitation Engineering Laboratory, Department of Health Sciences and TechnologyRehabilitation Engineering Laboratory, Department of Health Sciences and TechnologyAbstract Background Unsupervised robot-assisted rehabilitation is a promising approach to increase the dose of therapy after stroke, which may help promote sensorimotor recovery without requiring significant additional resources and manpower. However, the unsupervised use of robotic technologies is not yet a standard, as rehabilitation robots often show low usability or are considered unsafe to be used by patients independently. In this paper we explore the feasibility of unsupervised therapy with an upper limb rehabilitation robot in a clinical setting, evaluate the effect on the overall therapy dose, and assess user experience during unsupervised use of the robot and its usability. Methods Subacute stroke patients underwent a four-week protocol composed of daily 45 min-sessions of robot-assisted therapy. The first week consisted of supervised therapy, where a therapist explained how to interact with the device. The second week was minimally supervised, i.e., the therapist was present but intervened only if needed. After this phase, if participants learnt how to use the device, they proceeded to two weeks of fully unsupervised training. Feasibility, dose of robot-assisted therapy achieved during unsupervised use, user experience, and usability of the device were evaluated. Questionnaires to evaluate usability and user experience were performed after the minimally supervised week and at the end of the study, to evaluate the impact of therapists’ absence. Results Unsupervised robot-assisted therapy was found to be feasible, as 12 out of the 13 recruited participants could progress to unsupervised training. During the two weeks of unsupervised therapy participants on average performed an additional 360 min of robot-assisted rehabilitation. Participants were satisfied with the device usability (mean System Usability Scale scores > 79), and no adverse events or device deficiencies occurred. Conclusions We demonstrated that unsupervised robot-assisted therapy in a clinical setting with an actuated device for the upper limb was feasible and can lead to a meaningful increase in therapy dose. These results support the application of unsupervised robot-assisted therapy as a complement to usual care in clinical settings and pave the way to its application in home settings. Trial registration Registered on 13.05.2020 on clinicaltrials.gov (NCT04388891).https://doi.org/10.1186/s12984-024-01347-4StrokeNeurorehabilitationRobot-assisted therapyUnsupervised rehabilitationSelf-directed rehabilitationNeurocognitive therapy |
| spellingShingle | Giada Devittori Daria Dinacci Davide Romiti Antonella Califfi Claudio Petrillo Paolo Rossi Raffaele Ranzani Roger Gassert Olivier Lambercy Unsupervised robot-assisted rehabilitation after stroke: feasibility, effect on therapy dose, and user experience Journal of NeuroEngineering and Rehabilitation Stroke Neurorehabilitation Robot-assisted therapy Unsupervised rehabilitation Self-directed rehabilitation Neurocognitive therapy |
| title | Unsupervised robot-assisted rehabilitation after stroke: feasibility, effect on therapy dose, and user experience |
| title_full | Unsupervised robot-assisted rehabilitation after stroke: feasibility, effect on therapy dose, and user experience |
| title_fullStr | Unsupervised robot-assisted rehabilitation after stroke: feasibility, effect on therapy dose, and user experience |
| title_full_unstemmed | Unsupervised robot-assisted rehabilitation after stroke: feasibility, effect on therapy dose, and user experience |
| title_short | Unsupervised robot-assisted rehabilitation after stroke: feasibility, effect on therapy dose, and user experience |
| title_sort | unsupervised robot assisted rehabilitation after stroke feasibility effect on therapy dose and user experience |
| topic | Stroke Neurorehabilitation Robot-assisted therapy Unsupervised rehabilitation Self-directed rehabilitation Neurocognitive therapy |
| url | https://doi.org/10.1186/s12984-024-01347-4 |
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