Bilateral robot therapy based on haptics and reinforcement learning: Feasibility study of a new concept for treatment of patients after stroke.

Full Abstract

OBJECTIVE: To carry out a preliminary feasibility study of a new concept of robot therapy for severely impaired patients after stroke. DESIGN: A haptic manipulandum connected to a bar that can rotate freely while providing a measure of the rotation angle. The controller combines a bilateral reaching task with the task of balancing the action of the 2 arms. Reinforcement is given to the subject in 2 forms: audio-visual and haptic by means of adaptable force fields. PATIENTS: Four highly paretic patients with chronic stroke (Fugl-Meyer score less than 15). METHODS: The training cycle consisted of 5 sessions over a period of 2 weeks. Each session (45 min) was divided in blocks of 10 pairs of forward/backward movements. Performance was determined by evaluating the number of successful movements per session, the session-by-session decrease in the assistive field, the mean reaching time, and the mean stopping field. RESULTS: All subjects could understand the task, appreciated it and improved their performance during training. The reaching movements became smoother and quicker; balance errors and the magnitude of the resisting field were consistently reduced. CONCLUSION: Bilateral robot therapy is a promising technique, provided that it self-adapts to the patient's performance. Formal clinical trials should address this point.

Author information

Author/s: Squeri, Valentina (V); Casadio, Maura (M); Vergaro, Elena (E); Giannoni, Psiche (P); Morasso, Pietro (P); Sanguineti, Vittorio (V);

Affiliation: Istituto Italiano di Tecnologia, Via Morego 30, IT-16163 Genova, Italy. valentina.squeri(-atsign-)iit.it

Journal and publication information

Publication Type: Journal Article; Research Support, Non-U.S. Gov't

Journal: Journal of rehabilitation medicine : official journal of the UEMS European Board of Physical and Rehabilitation Medicine (J Rehabil Med), published in Sweden. (Language: eng)

Reference: 2009-Nov; vol 41 (issue 12) : pp 961-5

Dates: Created 2009/10/20; Completed 2009/10/27;

PMID: 19841824, status: MEDLINE (last retrieval date: 10/27/2009, IMS Date: )

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