Robotic therapy for the hemiplegic shoulder pain: a pilot study

Ruthber Rodríguez Serrezuela,Mauricio Torres Quezada,Marcia Hernández Zayas,Daily Milanés Hermosilla,Arquímedes Montoya Pedrón,Roberto Sagaró Zamora

doi:10.1186/s12984-020-00674-6

Abstract

BackgroundsExoskeletons development arises with a leading role in neurorehabilitation technologies; however, very few prototypes for upper limbs have been tested, contrasted and duly certified in terms of their effectiveness in clinical environments in order to incorporate into the health system. The purpose of this pilot study was to determine if robotic therapy of Hemiplegic Shoulder Pain (HSP) could lead to functional improvement in terms of diminishing of pain, spasticity, subluxation, the increasing of tone and muscle strength, and the satisfaction degree.MethodsAn experimental study was conducted in 16 patients with painful shoulder post- ischemic stroke in two experimental groups: conventional and robotic therapy. At different stages of its evolution, the robotic therapy effectiveness applied with anti-gravitational movements was evaluated. Clinical trial was developed at the Physical Medicine and Rehabilitation Department of the Surgical Clinical Hospital “Dr. Juan Bruno Zayas Alfonso” in Santiago de Cuba, from September 2016 - March 2018. Among other variables: the presence of humeral scapular subluxation (HSS), pain, spasticity, mobility, tone and muscle strength, and the satisfaction degree were recorded. Results with 95% reliability were compared between admission and third months of treatment. The Mann-Whitney U-Test, Chi-Square and Fisher’s Exact Tests were used as comparison criteria.ResultsRobotic therapy positively influenced in the decrease and annulment of pain and the spasticity degree, reaching a range increase of joint movement and the improvement of muscle tone.

Highlights

The World Health Organization (WHO) consider neurorehabilitation as an active process where some individuals, with some injury or neurological disease, could achieve the most optimal integral recovery in order to integrate their activities with the environment in the most appropriate approach
It can be seen after 3 months of robotic therapy, patients experienced a significant recovery in relation to the control group
The results obtained from the different indicators, it is deductible that the patients who received robotic rehabilitation exhibited higher rates of motor recovery

Summary

Introduction

The World Health Organization (WHO) consider neurorehabilitation as an active process where some individuals, with some injury or neurological disease, could achieve the most optimal integral recovery in order to integrate their activities with the environment in the most appropriate approach. Neurorehabilitation technologies have undergone important changes in the last years due to an exponential increase (according to the health systems data) of cerebrovascular accidents (CVA). In 50÷70% of survivors remain sequels, and about a third are unable to fend for themselves, calculating that approximately 75% lose their ability to return to work [3] This entity represents the fourth national cause of potentially lost life years, with around 11 years for a rate of 86.9 per 1000 inhabitants [4]. More than 100 prototypes have been developed in Serrezuela et al Journal of NeuroEngineering and Rehabilitation (2020) 17:54 recent years, only 10 have been clinically tested and they are commercial. Nowadays there is not enough clinical evidence, some reports include the possibility to improve the functional result after the CVA [8,9,10,11,12,13]

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