Comparison of robotic and clinical motor function improvement measures for sub-acute stroke patients

Abstract

In this paper, preliminary results in motor function improvement for four sub-acute stroke patients that underwent a hybrid robotic and traditional rehabilitation program are presented. The therapy program was scheduled for three days a week, four hours per day (approximately 60% traditional constraint induced therapy activities and 40% robotic therapy). A haptic joystick was used to implement four different operating modes for robotic therapy: unassisted (U), constrained (C), assisted (A), and resisted (R) modes. A target hitting task involving the positioning of a pointer on twelve targets was completed by the patients. Two different robotic measures were utilized to quantify the motor function improvement through the sessions: trajectory error (TE) and smoothness of movement (SM). Fugl-Meyer (FM) and motor activity log (MAL) scales were used as clinical measures. Analysis of results showed that the group demonstrates a significant motor function improvement with respect to both clinical and robotic measures. Regression analyses were carried out on corresponding clinical and robotic measure result pairs. A significant relation between FM scale and robotic measures was found for both of the analyzed modes. Regression of robotic measures on MAL scores resulted in no significance. A regression analysis that compared the two clinical measures revealed a very low agreement. Our findings suggest that it might be possible to obtain objective robotic measures that are significantly correlated to widely-used and reliable clinical measures in considerably different operating modes and control schemes.